Gastric Cancer ICD 10 Code

Refresher: What are ICD-10 Codes?

International Classification of Diseases (ICD) codes are specific codes that are used to communicate the type of disease for healthcare professionals and medical claims purposes or to classify any abnormal medical findings. The ICD codes provide a way of identifying diseases that are universally accepted in the medical as well as insurance field. The ICD-10 is the tenth and final edition of the coding system thus far.

ICD-10 stands for the International Classification of Diseases, 10th revision. It is a coding system used in healthcare to systematically classify diagnoses, procedures, and symptoms. CM indicates “Clinical Modification,” and is used in the U.S. for disease diagnoses (ICD-10-CM). ICD-10-PCS codes are used for coding procedures in inpatient settings.

Both of these coding systems are used for medical claims and statistics purposes. In general, ICD-10 codes are different for primary tumors (“malignant neoplasms [1]”) and secondary or metastasized tumors (“secondary malignant neoplasms”).

The ICD-10 codes are passed on to insurance providers to establish the medical necessity of services a provider is claiming for. Currently, there are over 70,000 ICD-10 codes [2] that are in use for the classification of medical conditions. The ICD-10 codes can be found on the paperwork and bills of the patient, which is why using the right classification is crucial for medical reimbursements. If the code is used incorrectly, it can result in the insurance provider refusing a claim or having one's treatment denied. Knowing the ICD-10 codes is crucial if the insurance claim has been disputed by the provider, if the insurance claim has not been paid, and if a pre-approval of a certain type of treatment has been denied.

What is the ICD 10 Code for Gastric Cancer?

For primary gastric cancer tumors [3], the general ICD-10 code is C16.9 (malignant neoplasm of the stomach, whereas for secondary or metastatic tumors, the ICD-10 code is C16 (secondary malignant neoplasm of the stomach).

Primary Gastric Cancer ICD 10 Code: C16.9

The tissue in the body is made up of cells. Cancer is the uncontrollable multiplying of these cells. This abnormal multiplying of the cells leads to abnormal growth of tissue or malignant neoplasm. Cancer cells tend to destroy healthy tissue as well, along with spreading throughout the body.

Primary Gastric Cancer ICD Code C16.9 Lookup

Below is a table of the ICD 10 gastric cancer codes for primary gastric cancers, which are classified under C16.9, “malignant neoplasm of the stomach.” [4]

C34: Malignant neoplasm of the stomach

ICD 10 gastric cancer codes

Types of Gastric cancer coded under C16.9

The ICD-10 code, C16.9 is a billable code that is used to identify the medical diagnosis of neoplasm of the stomach (unspecified). The code covers HIPAA-covered transactions. The unspecified diagnosis codes such as C16.9 are suitable for clinical information that is either unknown or unavailable regarding a particular medical condition, which in this case, is gastric cancer.

While a more specific code is desirable, unspecified codes are used whenever they can accurately reflect the medical condition of the patient. The types of conditions that are also coded under C16.9 include; adenocarcinoma, carcinoma (malignant), leather bottle stomach, and Linitis plastica.

Gastric cancers excluded from ICD-10 C16.9

The coding system excludes malignant carcinoid tumors of the stomach (C7A.092). This is a primary or metastatic malignant neoplasm that involves the stomach.

Secondary and metastatic gastric cancer ICD 10 code: C16.9

Secondary and metastatic gastric cancer ICD-10 C16.9 is used to indicate a diagnosis for the reimbursement of funds by insurance providers. This type of cancer is more common in men as compared to women and more common among older people. While gastric cancer peaks in the elderly, a delay in its diagnosis usually results in a poor prognosis. Thankfully, dedicated research into risk factors, treatment options, and advanced testing methods have led to the early detection of gastric cancer.

Secondary or metastatic Gastric cancer ICD-10 code C16.9 lookup

Metastatic stomach cancer is considered to be a malignancy that originates from within the stomach and then spreads to other parts of the body. In most common cases, stomach cancer that has metastasized has reached other organs such as the lungs, liver, and abdominal lining.[5]

Conclusion

Gastric cancer was once the second most common type of cancer in the world. Today, gastric cancer is the sixth most common type of cancer and the fourth most common cause of death in the world. While the rates of gastric cancer-related deaths are relatively low nowadays, they still require proper classification with the help of the right ICD-10 codes for treatment options and medical reimbursements.[6]