Rectal Cancer ICD 10 Code

Refresher: What are ICD-10 codes?

ICD-10 is the tenth edition of the International Classification of Diseases. It serves as a catalog of codes that helps healthcare providers diagnose diseases. There is a code for every type of condition depending on its location and origins.

Currently, ICD-10 is the most updated version of the catalog since it has undergone many revisions over the years. Taking over ICD-9, ICD-10 has significantly helped health practitioners by providing in-depth detail about every disease/condition.

The 10th edition has over 68,000 codes which facilitate better diagnostic accuracy and better outcomes for patients. ICD-10 codes are divided into two broad categories:

ICD-10-CM (Clinical Modification)

ICD-10-PCS (Procedure Coding System)

While ICD-10-PCS uses codes specific to inpatient coding, ICD-10-CM codes are diagnostic codes that classify various types of tumors. Since 1979, the US has been using ICD-9. However, over time, ICD-9 became stagnant and failed to serve the healthcare needs of the modern world. This is what triggered the development of ICD-10, a much more detailed version of the catalog [1].

What is the ICD 10 code for rectal cancer?

For primary rectal cancer, the general ICD-10 code is C20 (malignant neoplasm of the rectum). For secondary malignant neoplasm of the large intestine and rectum, the ICD-10 code is C78.5. [2].

Rectal cancer is a type of cancer in which there are malignant cells in the rectum tissue. Common signs of rectal cancer include the following:

Blood in the stool

Change in bowel habits

Rectal cancer is diagnosed through tests that examine the colon and rectum.

Primary rectal cancer ICD 10 code: C20

Primary rectal cancer ICD code C20 lookup

Below is a table of the ICD 10 codes for “malignant neoplasms of digestive organs” (C15-C26) which also includes “malignant neoplasm of rectum” (C20) [3].

C15-C26: Malignant neoplasms of digestive organs

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Text here...Types of rectal cancer coded under C20

The ICD 10 code C20 does not specify the subtype of rectal cancer. However, it represents a primary or malignant neoplasm that affects the rectum. Representative examples include:

Sarcoma (It is an umbrella term for cancers that begin in the bones and in the soft tissues)
Lymphoma (While it commonly starts in the lymph nodes, it can also start in the rectum)
Carcinoma (This type begins in the tissues or the skin that covers internal organs)

Most people with rectal cancer have a type known as adenocarcinoma, which is a subtype of carcinoma. This type of cancer affects the cells that line the rectum interior.

Rectal cancers excluded from ICD-10 C20

ICD-10-C20 excludes:

Malignant carcinoid tumor of the rectum (C7A.026) [⁴]
Malignant neoplasm of overlapping sites of rectum, anus, and anal canal (C21.8) [⁵]

A malignant carcinoid tumor of the rectum or rectal carcinoid tumor is an uncommon tumor. In most cases, it is discovered during an evaluation of rectal bleeding symptoms or during a colonoscopy, or during the evaluation of diarrhea.

These tumors are extremely small, and there are no standard treatments for them since there isn't enough literature to support them. It's important to note that rectal carcinoid tumors do not usually metastasize.

In malignant neoplasm of overlapping sites of rectum, the term “overlapping” implies that the sites are next to each other or contiguous. So, code C21.8 suggests that you have cancer of the anus, anal canal, or rectum. However, it doesn't come under C20 because it also includes the anus.

ICD-10-C20 also excludes malignant neoplasms of other digestive organs such as:

Esophagus
Stomach
Small intestine
Colon
Anus
Liver
Gall bladder
Pancreas

Secondary malignant neoplasm of large intestine and rectum ICD 10 code: C78.5

Secondary malignant neoplasm of large intestine and rectum ICD-10 code C78.5 lookup

The ICD-10 code for secondary malignant neoplasm of the large intestine and rectum is C78.5. The code suggests that you have metastases in your large intestine and rectum. This means that the cancer cells have multiplied to the extent that they have spread to other parts of the body (in this case, the large intestine and rectum).

It's important to note that rectal cancer is not the same as colorectal cancer. The latter involves the small and large intestines, while the former is limited to the rectum in the primary stages. If it spreads to distant organs, it is called metastatic rectal cancer.

Conclusion

The ICD-10 code for rectal cancer depends on its specific location. Since there are overlapping sites involved in some cases, such as the anus, it's important to be certain about the code.

Malignant neoplasm falls under ICD-10 C20, whereas secondary malignant neoplasm of large intestine and rectum is coded under C78.5. The ICD-10 helps healthcare practitioners specify the type of cancer and whether there are nearby areas involved, which may be useful in creating a treatment plan for the patient.