ICD-10 Coding for Carcinomatosis(C78.6, C80.1)
Complete ICD-10-CM coding and documentation guide for Carcinomatosis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Carcinomatosis
C78-C79Primary Range
Secondary malignant neoplasms
This range includes codes for secondary malignant neoplasms, including peritoneal carcinomatosis.
Malignant neoplasm of retroperitoneum and peritoneum
This range includes primary malignant neoplasms of the peritoneum, which must be differentiated from secondary neoplasms.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| C78.6 | Secondary malignant neoplasm of retroperitoneum and peritoneum | Use when there is a confirmed secondary malignant neoplasm in the peritoneum. |
|
| C80.1 | Malignant (primary) neoplasm, unspecified | Use when the primary site of the malignancy is unknown. |
|
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 peritoneal carcinomatosis
Essential facts and insights about Carcinomatosis
Primary ICD-10-CM Codes for carcinomatosis
Decision Criteria
clinical Criteria
- Presence of metastatic disease in the peritoneum confirmed by imaging and pathology.
coding Criteria
- Primary malignancy must be coded if known.
Applicable To
- Peritoneal carcinomatosis
Excludes
- Primary peritoneal carcinoma (C48.2)
Clinical Validation Requirements
- Imaging showing peritoneal thickening or nodularity
- Biopsy confirming metastatic adenocarcinoma
Code-Specific Risks
- Incorrectly using without a primary malignancy code
Coding Notes
- Ensure documentation specifies the primary site if known.
C80.1 - Malignant (primary) neoplasm, unspecified
Use when the primary site of the malignancy is unknown.
Clinical Validation Requirements
- Lack of documentation specifying the primary site
Coding Notes
Use only when the primary site cannot be determined.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Encounter for antineoplastic chemotherapy
Z51.11Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Carcinomatosis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code C78.6.
Impact
Clinical: May lead to inappropriate treatment decisions., Regulatory: Non-compliance with coding standards., Financial: Potential for denied claims.
Mitigation Strategy
Ensure documentation reflects current treatment status., Use active treatment codes when applicable.
Impact
Reimbursement: May lead to incorrect DRG assignment and reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate representation of the patient's condition.
Mitigation Strategy
Always link to the primary malignancy code.
Impact
Primary malignancy codes must precede secondary codes unless the primary is unknown.
Mitigation Strategy
Review coding guidelines and ensure proper sequencing.
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 Carcinomatosis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Carcinomatosis
Use these documentation templates to ensure complete and accurate documentation for Carcinomatosis. These templates include all required elements for proper coding and billing.
Oncology follow-up visit
Specialty: OncologyRequired Elements
- Patient history
- Current treatment plan
- Imaging results
- Pathology findings
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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