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ICD-10 Coding for Stomach Carcinoma(C16.0, C16.1, C16.9)

Complete ICD-10-CM coding and documentation guide for Stomach Carcinoma. Includes clinical validation requirements, documentation requirements, and coding pitfalls.

Also known as:

Gastric CancerGastric Carcinoma

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Related ICD-10 Code Ranges

Complete code families applicable to Stomach Carcinoma

C16.0-C16.9Primary Range

Malignant neoplasm of stomach

This range covers all primary malignant neoplasms of the stomach, including specific sites such as cardia, antrum, body, and pylorus.

C7A.092

Malignant carcinoid tumor of stomach

This code is used for neuroendocrine tumors of the stomach, which are a specific type of gastric neoplasm.

K31A0-K31A29

Gastric intestinal metaplasia

These codes are used for documenting precursor conditions to gastric cancer, such as gastric intestinal metaplasia.

Code Comparison: When to Use Each Code

Compare key differences between these codes to ensure accurate selection

CodeDescriptionWhen to UseKey Documentation
C16.0Malignant neoplasm of cardiaUse when the tumor is located at the gastric cardia.
  • Biopsy-confirmed adenocarcinoma located at the gastric cardia
  • Imaging showing tumor at the cardia
C16.1Malignant neoplasm of pylorusUse when the tumor is located at the gastric pylorus.
  • Biopsy-confirmed adenocarcinoma located at the pylorus
  • Endoscopy showing tumor at the pylorus
C16.9Malignant neoplasm of stomach, unspecifiedUse when the specific site of the gastric tumor is not documented.
  • Imaging or clinical diagnosis of gastric cancer without specific site documentation

Clinical Decision Support

Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.

Key Information: ICD-10 code for carcinoma stomach

Essential facts and insights about Stomach Carcinoma

The ICD-10 code for carcinoma of the stomach is C16.x, with specific codes for different stomach regions.

Primary ICD-10-CM Codes for carcinoma stomach

C16.0
Malignant neoplasm of cardia
Billable Code

Decision Criteria

clinical Criteria

  • Biopsy confirms adenocarcinoma at the gastric cardia.

Applicable To

  • Cancer of the gastric cardia

Excludes

  • Esophageal cancer (C15.x)

Clinical Validation Requirements

  • Biopsy-confirmed adenocarcinoma located at the gastric cardia
  • Imaging showing tumor at the cardia

Code-Specific Risks

  • Misclassification with esophageal cancer

Coding Notes

  • Ensure precise documentation of tumor location to avoid misclassification.
View Full Code Details

Ancillary Codes

Additional codes that should be used in conjunction with the main diagnosis codes when applicable.

Gastric intestinal metaplasia

K31.A1X
Use to document precursor conditions that may lead to gastric cancer.

Epigastric pain

R10.1
Use to document symptoms associated with gastric cancer.

Secondary peritoneal carcinomatosis

C78.6
Use to document metastatic spread to the peritoneum.

Differential Codes

Alternative codes to consider when ruling out similar conditions to the primary diagnosis.

Malignant neoplasm of lower third of esophagus

C15.5
Differentiate based on tumor location; use C16.0 if the tumor is primarily in the gastric cardia.

Malignant neoplasm of duodenum

C17.0
Differentiate based on tumor location; use C16.1 if the tumor is primarily in the pylorus.

Malignant neoplasm of cardia

C16.0
Use C16.9 only if the specific site is not documented.

Documentation & Coding Risks

Avoid these common documentation and coding issues when documenting Stomach Carcinoma to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code C16.0.

Impact

Clinical: Impacts treatment decisions, Regulatory: Non-compliance with documentation standards, Financial: Potential for denied claims

Mitigation Strategy

Ensure biopsy reports include histology

Impact

Reimbursement: May lead to lower reimbursement, Compliance: Non-compliance with coding guidelines, Data Quality: Decreased data specificity

Mitigation Strategy

Ensure the specific site is coded if documented

Impact

Frequent use of C16.9 when specific site is documented

Mitigation Strategy

Ensure documentation specifies tumor site

Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.

Frequently Asked Questions

Common questions about ICD-10 coding for Stomach Carcinoma, with expert answers to help guide accurate code selection and documentation.

Documentation Templates for Stomach Carcinoma

Use these documentation templates to ensure complete and accurate documentation for Stomach Carcinoma. These templates include all required elements for proper coding and billing.

Biopsy-confirmed gastric adenocarcinoma

Specialty: Gastroenterology

Required Elements

  • Patient history
  • Imaging findings
  • Biopsy results
  • Staging information

Example Documentation

Patient presents with epigastric pain and weight loss. CT shows a mass in the gastric antrum. Biopsy confirms moderately differentiated adenocarcinoma.

Examples: Poor vs. Good Documentation

Poor Documentation Example
Patient has stomach cancer.
Good Documentation Example
Patient diagnosed with moderately differentiated adenocarcinoma of the gastric antrum, confirmed by biopsy.
Explanation
The good example specifies the histology and location, improving coding accuracy.

Need help with ICD-10 coding for Stomach Carcinoma? Ask your questions below.

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