ICD-10 Coding for Stomach Cancer(C16.0, C16.9)
Complete ICD-10-CM coding and documentation guide for Stomach Cancer. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Stomach Cancer
C16.0-C16.9Primary Range
Malignant neoplasm of stomach
This range includes all primary malignant neoplasms of the stomach, specifying different anatomical sites.
Secondary malignant neoplasm of other specified sites
Used for coding metastasis from a primary gastric cancer to other sites.
Personal history of malignant neoplasm of stomach
Used for patients with a history of gastric cancer that has been treated and is no longer active.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| C16.0 | Malignant neoplasm of cardia | Use when the tumor is located at the gastric cardia. |
|
| C16.9 | Malignant neoplasm of stomach, unspecified | Use when the specific site of the stomach cancer is not documented. |
|
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 malignant neoplasm of stomach
Essential facts and insights about Stomach Cancer
Primary ICD-10-CM Codes for malignant neoplasm of stomach
Decision Criteria
clinical Criteria
- Biopsy confirms adenocarcinoma at cardia
Applicable To
- Adenocarcinoma of gastric cardia
Excludes
- Benign neoplasm of cardia
Clinical Validation Requirements
- Endoscopic biopsy confirming adenocarcinoma
- Imaging showing mass at cardia
Code-Specific Risks
- Misclassification if tumor extends beyond cardia
Coding Notes
- Ensure documentation specifies the exact location within the stomach.
C16.9 - Malignant neoplasm of stomach, unspecified
Use when the specific site of the stomach cancer is not documented.
Applicable To
- Stomach cancer NOS
Excludes
- Specific site neoplasms of stomach
Clinical Validation Requirements
- Imaging or biopsy confirming gastric cancer without specific site documentation
Coding Notes
Avoid using this code when specific site information is available.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Stomach Cancer to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code C16.0.
Impact
Clinical: Inaccurate representation of disease extent., Regulatory: Non-compliance with coding guidelines., Financial: Potential loss of reimbursement for metastatic sites.
Mitigation Strategy
Review imaging and pathology for metastasis, Include all relevant secondary site codes
Impact
Reimbursement: Potential underpayment due to lack of specificity., Compliance: Increased audit risk., Data Quality: Decreased accuracy of clinical data.
Mitigation Strategy
Ensure specific site is coded when documented (e.g., C16.0 for cardia).
Impact
Audits may target cases where C16.9 is used without site specificity.
Mitigation Strategy
Ensure documentation includes specific tumor location.
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 Cancer, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Stomach Cancer
Use these documentation templates to ensure complete and accurate documentation for Stomach Cancer. These templates include all required elements for proper coding and billing.
Pathology report for gastric cancer
Specialty: PathologyRequired Elements
- Tumor location
- Histological type
- Margins
- Lymphovascular invasion
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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