Pancreatic Cancer ICD 10 Code

Refresher: What Are ICD 10 Codes?

ICD-10 stands for the International Classification of Diseases, 10th revision. It is a coding system used in healthcare to classify diagnoses, procedures, and symptoms systematically. CM indicates “Clinical Modification,” which 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.

The ICD coding system emerged in the 1850s, with the first coding edition known as the International List of Causes of Death. The initial version was adopted by the International Statistical Institute in 1893. WHO assumed the International Classification of Diseases (ICD) oversight in 1948 to track and eliminate diseases from various populations. The organization introduced the Sixth Revision (ICD 6) at that time to identify the causes of morbidity in the pre-defined coding system. WHO continued to formulate and launch new editions to overcome the problems of the previous versions. The organization published ICD 7 and ICD 8 in 1957 and 1968, respectively. By 1979, WHO had published the Ninth Revision (ICD 9) of the coding system, creating an opportunity for the U.S. to develop an exclusive version of the Ninth Revision, ICD 9-CM (clinical modification). [¹]

The Ninth Revision, clinical modification (ICD 9-CM) allowed further developments to capture enhanced morbidity data. This (U.S.) new edition also incorporated surgical procedures and other parameters necessary for categorizing the needs of hospitals. While the Ninth Revision encompassed several crucial variables, ICD 9-CM (updated by CMS and the NCHS) had a limited capacity to add codes. After years of research, planning, and development, CMS and the NCHS introduced a new system, ICD 10-CM (Tenth Revision, clinical modification), to establish a comprehensive classification system to address the limitations of the Ninth Revision.

In general, ICD-10 codes are different for primary cancers (“malignant neoplasms”) and for metastatic lung cancer (“secondary malignant neoplasms”). [²]

What Is the ICD 10 Code for Pancreatic Cancer?

For primary pancreatic cancer tumors, the general ICD-10 code is C25 (malignant neoplasm of the pancreas), whereas for secondary or metastatic tumors, the ICD-10 code is C78.89 (secondary malignant neoplasm of other digestive organs).

Primary Pancreatic Cancer ICD 10 Code: C25

Primary Pancreatic Cancer ICD Code C25 Lookup

Below is the table of the ICD 10 pancreatic cancer codes for primary pancreatic cancers, which are classified under C25, “malignant neoplasm of pancreas.” [³]

Types of Pancreatic Cancer Coded Under C25

The ICD 10 code C25 does not specify the subtype of pancreatic cancer. A C25 code can also apply to the primary pancreatic cancers of various cell types. The following list covers the cell types to give you a better idea.

• Pancreatic Adenocarcinomas (located in the pancreatic duct)
• Adenosquamous Carcinomas
• Squamous Cell Carcinomas
• Signet Ring Cell Carcinomas
• Undifferentiated Carcinomas
• Undifferentiated Carcinomas With Giant Cells
• Ampullary Cancers

In other words, pancreatic adenocarcinomas ICD 10, adenosquamous carcinomas ICD 10, squamous cell carcinomas ICD 10, signet ring cell carcinomas ICD 10, undifferentiated carcinomas ICD 10, and ampullary cancer ICD 10 codes could all be C25 if they are determined to be primary malignant neoplasms of the pancreas. To exemplify, a patient diagnosed with stage I pancreatic adenocarcinoma, with the tumor located in the pancreatic duct, would be coded with C25.3.

Secondary and Metastatic Pancreatic Cancer ICD 10 Code: C78.89

Secondary or Metastatic Pancreatic Cancer ICD 10 Code C78.89 Lookup

Secondary or metastatic cancers spread from other parts of the body after affecting the primary site. The cancers metastasized from other locations may form the same tumor as in the primary site. The ICD 10 pancreatic cancer code for secondary pancreatic cancers, or pancreatic cancers metastasized from other locations, is C78.89, “secondary malignant neoplasm of other and digestive organs.” [⁴]

Conclusion

The ICD 10 code for pancreatic cancer varies due to the position of the tumor and the formation of the neoplasm (primary or secondary). Pancreatic cancer ICD 10 codes are categorized into six main subsites (head of the pancreas, body of the pancreas, tail of the pancreas, pancreatic duct, endocrine pancreas, and other parts of the pancreas), followed by overlapping and unspecified sites. Primary pancreatic cancers fall under ICD 10 C25, and secondary cancers lie in C78.89. It is worth remembering that the ICD 10 code does not specify the exact pancreatic cancer type. The codes can be the same if two different types of pancreatic cancer are located in the same part. The origin and pathophysiology of pancreatic tumors and the patient’s condition are crucial in determining the ICD 10 coding.