Gastric Cancer ICD-10 Codes

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Confused about ICD-10 codes for gastric cancer, adenocarcinoma, metastasis, or tumors?

Accurate ICD-10 coding is crucial for gastric cancer diagnosis, treatment, billing, and research. This guide demystifies codes for all major gastric cancer types, including adenocarcinoma, metastatic disease, and tumors. Whether you’re a coder, clinician, or patient, find the precise codes you need

Core ICD-10 Codes for Gastric Cancer & Adenocarcinoma

  1. Gastric Cancer / Stomach Cancer (Malignant Neoplasm of Stomach):
    • ICD-10-CM Code: C16.X
    • Details: This is the parent code for any primary malignant tumor originating in the stomach. The fourth digit (X) specifies the exact anatomical location:
      • C16.0 Cardia (Upper part near esophagus)
      • C16.1 Fundus (Upper curvature)
      • C16.2 Body (Main central section)
      • C16.3 Pyloric Antrum (Exit funnel)
      • C16.4 Pylorus (Sphincter muscle exit)
      • C16.5 Lesser Curvature (Inside curve)
      • C16.6 Greater Curvature (Outside curve)
      • C16.8 Overlapping Lesion (Tumor involves multiple regions)
      • C16.9 Stomach, Unspecified (Used when location isn’t documented)
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  2. Gastric Adenocarcinoma:
    • ICD-10-CM Code: C16.X (Same as above)
    • Details: Adenocarcinoma accounts for 90-95% of all gastric cancers. While histology (adenocarcinoma) is critical for pathology reports and treatment planning, the primary ICD-10 code is still based on the tumor’s location within the stomach (C16.X). The specific adenocarcinoma type (e.g., tubular, papillary, signet ring cell) is captured in pathology codes (e.g., ICD-O-3 morphology codes like 8140/3), not the primary diagnosis code for billing/statistics.
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Coding Metastatic Gastric Cancer

  1. Metastatic Gastric Cancer / Metastatic Gastric Adenocarcinoma:
    • Primary Tumor Code: C16.X (Specify location if known, otherwise C16.9).
    • Secondary Metastasis Code(s):C78.X (Secondary malignant neoplasm of other sites). The sixth digit specifies the metastatic site:
      • C78.0 Lung
      • C78.00 Lung, unspecified side
      • C78.01 Right lung
      • C78.02 Left lung
      • C78.1 Mediastinum
      • C78.2 Pleura
      • C78.3 Other respiratory sites
      • C78.4 Small intestine
      • C78.5 Large intestine and rectum
      • C78.6 Retroperitoneum and peritoneum (C78.6 is CRITICAL for peritoneal carcinomatosis, common in gastric cancer)
      • C78.7 Liver (A very common metastatic site)
      • C78.8 Other specified digestive organs
      • C78.80 Other digestive organs, unspecified
      • C78.89 Other digestive organs
      • C79.XX Codes for metastasis to other sites (e.g., C79.51 Bone, C79.31 Brain, C79.81 Ovary, C79.82 Other genital organs, C79.49 Other urinary organs, C79.9 Other sites).
    • Coding Guideline: BOTH codes are required. List the primary gastric cancer (C16.X) first, followed by the secondary metastasis code(s) (C78.X or C79.XX). This indicates the origin is the stomach and identifies where it has spread.
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Coding Gastric Tumors

  1. Gastric Tumor:
    • Malignant Tumor: C16.X (As above). “Tumor” often implies malignancy clinically.
    • Benign Tumor:
      • ICD-10-CM Code: D13.1 (Benign neoplasm of stomach).
      • Details: This covers non-cancerous growths like gastric polyps (adenomatous, hyperplastic), leiomyomas, lipomas, etc. Requires confirmation (usually biopsy) that the tumor is benign.
    • Uncertain Behavior: D37.1 (Neoplasm of uncertain behavior of stomach). Used when pathology can’t definitively classify as benign or malignant.
    • Unspecified Nature: D49.0 (Neoplasm of unspecified behavior of digestive system). Used only when no information on behavior is available (a last resort).
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Key Coding Guidelines & Best Practices

  • Specificity is King: Always use the most specific code possible. C16.9 (unspecified) should be avoided if location is documented (C16.0-C16.8).
  • Laterality: Stomach cancer codes (C16.X) do not use laterality (left/right). Metastasis codes (C78.X, C79.XX) often do.
  • Metastasis Coding: Never use only a metastasis code (C78.X/C79.XX) for a known primary gastric cancer. The primary (C16.X) must always be coded first.
  • Histology Matters Clinically, Not Primarily in ICD-10 Code: While adenocarcinoma is overwhelmingly common, other types exist (lymphoma C85.9-, GIST C49.A-, neuroendocrine C7A.092). Their primary codes are different. Ensure the diagnosis aligns with the code.
  • Documentation: Clear physician documentation of tumor location, behavior (malignant/benign), and metastatic sites is essential for accurate coding.
  • Combination Codes: For certain complications directly related to the cancer (e.g., gastric outlet obstruction due to the tumor), combination codes like C16._ + K31.1 (Adult hypertrophic pyloric stenosis) or C16._ + K91.89 (Other postprocedural complications of digestive system) might be needed, but the cancer code remains primary.

FAQs: Gastric Cancer ICD-10 Codes

Q: What is the most common ICD-10 code for stomach cancer?

A: C16.9 (Malignant neoplasm of stomach, unspecified) is frequently used, but coders should strive for more specific location codes (C16.0-C16.8) when documented.

Q: Is there a different code for gastric adenocarcinoma?

A: No. The primary ICD-10 code is based on location (C16.X). The adenocarcinoma histology is documented separately in the medical record and pathology reports.

Q: How do I code cancer that started in the stomach but spread to the liver?

A: Code C16.X (specify stomach location) FIRST, followed by C78.7 (Secondary malignant neoplasm of liver).

Q: What code is used for a benign stomach polyp?

A: D13.1 (Benign neoplasm of stomach).

Q: What if the pathology report says “suspicious for malignancy” or “indeterminate”?

A: Use D37.1 (Neoplasm of uncertain behavior of stomach) until a definitive diagnosis is made.

Conclusion
Mastering gastric cancer ICD-10 coding (C16.X for location, C78.X/C79.XX for metastasis, D13.1 for benign) ensures accurate patient records, appropriate reimbursement, and reliable cancer data. Always prioritize specificity based on documentation and adhere to sequencing rules, especially for metastatic disease. Keep this guide handy for quick reference!

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