ICD-10 Coding for Peritoneal Carcinoma(C48.2, C78.6)
Complete ICD-10-CM coding and documentation guide for Peritoneal Carcinoma. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Peritoneal Carcinoma
C48-C48.2Primary Range
Malignant neoplasm of retroperitoneum and peritoneum
Primary peritoneal carcinoma is coded within this range, specifically C48.2.
Secondary malignant neoplasm of respiratory and digestive organs
Secondary peritoneal carcinomatosis is coded within this range, specifically C78.6.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| C48.2 | Malignant neoplasm of peritoneum, unspecified | Use when the carcinoma originates in the peritoneum and is not secondary to another primary site. |
|
| C78.6 | Secondary malignant neoplasm of peritoneum | Use when the peritoneal carcinoma is secondary to another primary cancer. |
|
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 primary peritoneal carcinoma
Essential facts and insights about Peritoneal Carcinoma
Primary ICD-10-CM Codes for peritoneal carcinoma
Decision Criteria
clinical Criteria
- Histology confirms primary peritoneal origin without ovarian involvement.
documentation Criteria
- Documentation must exclude ovarian/fallopian tube origin.
Applicable To
- Primary peritoneal carcinoma
Excludes
- Secondary peritoneal carcinomatosis (C78.6)
Clinical Validation Requirements
- Histological confirmation of primary peritoneal origin
- Exclusion of ovarian/fallopian tube origin via imaging/histology
Code-Specific Risks
- Misclassification as secondary peritoneal carcinomatosis
Coding Notes
- Ensure documentation clearly differentiates between primary and secondary peritoneal carcinoma.
C78.6 - Secondary malignant neoplasm of peritoneum
Use when the peritoneal carcinoma is secondary to another primary cancer.
Applicable To
- Metastatic peritoneal carcinomatosis
Excludes
- Primary peritoneal carcinoma (C48.2)
Clinical Validation Requirements
- Evidence of metastasis from another primary site
- Imaging or biopsy confirming secondary involvement
Coding Notes
Ensure primary site is documented and coded alongside C78.6.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Peritoneal Carcinoma to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code C48.2.
Impact
Clinical: Impacts treatment decisions., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials.
Mitigation Strategy
Always document the primary site when coding secondary peritoneal carcinoma., Use structured templates to ensure completeness.
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate data on cancer prevalence and treatment.
Mitigation Strategy
Use C78.6 for secondary peritoneal involvement.
Impact
Misclassification of primary and secondary peritoneal carcinoma.
Mitigation Strategy
Implement thorough documentation reviews and training.
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 Peritoneal Carcinoma, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Peritoneal Carcinoma
Use these documentation templates to ensure complete and accurate documentation for Peritoneal Carcinoma. These templates include all required elements for proper coding and billing.
Primary peritoneal carcinoma diagnosis
Specialty: OncologyRequired Elements
- Histology report
- Imaging results
- Exclusion of ovarian origin
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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