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ICD-10 Coding for Gastric Carcinoma(C16.0, C16.3)

Complete ICD-10-CM coding and documentation guide for Gastric Carcinoma. Includes clinical validation requirements, documentation requirements, and coding pitfalls.

Also known as:

Stomach CancerGastric Cancer

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Related ICD-10 Code Ranges

Complete code families applicable to Gastric Carcinoma

C16.0-C16.9Primary Range

Malignant neoplasm of stomach

This range covers all primary malignant neoplasms of the stomach, including specific subsites.

C78.6

Secondary malignant neoplasm of retroperitoneum and peritoneum

Used for metastatic involvement of the peritoneum from gastric carcinoma.

Z51.11

Encounter for antineoplastic chemotherapy

Used when the primary reason for admission is chemotherapy for gastric carcinoma.

Code Comparison: When to Use Each Code

Compare key differences between these codes to ensure accurate selection

CodeDescriptionWhen to UseKey Documentation
C16.0Malignant neoplasm of cardiaUse when the tumor is located at the gastric cardia.
  • Histology report confirming adenocarcinoma
  • Imaging showing tumor at gastric cardia
C16.3Malignant neoplasm of pyloric antrumUse when the tumor is located in the pyloric antrum.
  • Histology report confirming adenocarcinoma
  • Imaging showing tumor in pyloric antrum

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 gastric carcinoma

Essential facts and insights about Gastric Carcinoma

The ICD-10 code for gastric carcinoma varies by tumor location: C16.0 for cardia, C16.3 for pyloric antrum.

Primary ICD-10-CM Codes for gastric carcinoma

C16.0
Malignant neoplasm of cardia
Billable Code

Decision Criteria

clinical Criteria

  • Tumor located at the gastric cardia

Applicable To

  • Adenocarcinoma of gastric cardia

Excludes

  • Benign neoplasm of cardia

Clinical Validation Requirements

  • Histology report confirming adenocarcinoma
  • Imaging showing tumor at gastric cardia

Code-Specific Risks

  • Misclassification if tumor extends beyond cardia

Coding Notes

  • Ensure documentation specifies the tumor's precise location within the stomach.
View Full Code Details

Ancillary Codes

Additional codes that should be used in conjunction with the main diagnosis codes when applicable.

Encounter for antineoplastic chemotherapy

Z51.11
Use when chemotherapy is the primary reason for the encounter.

Differential Codes

Alternative codes to consider when ruling out similar conditions to the primary diagnosis.

Malignant neoplasm of esophagus, unspecified

C15.9
Use C15.9 if the tumor is primarily esophageal with minor gastric involvement.

Malignant neoplasm of duodenum

C17.0
Use C17.0 if the tumor is primarily duodenal with minor gastric involvement.

Documentation & Coding Risks

Avoid these common documentation and coding issues when documenting Gastric Carcinoma to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code C16.0.

Impact

Clinical: May lead to inappropriate treatment decisions., Regulatory: Non-compliance with coding standards., Financial: Potential for denied claims or incorrect reimbursement.

Mitigation Strategy

Use standardized templates for pathology reports., Educate clinicians on the importance of detailed documentation.

Impact

Reimbursement: May lead to incorrect DRG assignment and reimbursement issues., Compliance: Non-compliance with coding guidelines., Data Quality: Reduces the accuracy of cancer registry data.

Mitigation Strategy

Always specify the subsite of the tumor within the stomach.

Impact

High risk of audits due to unspecified tumor location.

Mitigation Strategy

Implement mandatory fields in EHR for tumor subsite.

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 Gastric Carcinoma, with expert answers to help guide accurate code selection and documentation.

Documentation Templates for Gastric Carcinoma

Use these documentation templates to ensure complete and accurate documentation for Gastric Carcinoma. These templates include all required elements for proper coding and billing.

Gastric carcinoma pathology report

Specialty: Pathology

Required Elements

  • Tumor location
  • Histologic type
  • Margins
  • Lymphovascular invasion
  • pTNM staging

Example Documentation

## GASTRIC CARCINOMA PATHOLOGY PROFORMA **Specimen Type:** [ ] Distal gastrectomy [ ] Total gastrectomy **Tumor Location:** [X] Cardia (C16.0) [ ] Body (C16.1) [ ] Antrum (C16.3) **Histologic Type:** [ ] Intestinal [X] Diffuse [ ] Mixed **Margins:** - Proximal: 10mm clearance - Distal: 8mm clearance - Deep: Negative **Lymphovascular Invasion:** [X] Present [ ] Absent **pTNM:** pT3 pN1b(sn) pM0 **Ancillary Studies:** - HER2: Equivocal (IHC 2+) - MMR: MLH1/PMS2 deficient

Examples: Poor vs. Good Documentation

Poor Documentation Example
Gastric cancer identified
Good Documentation Example
Poorly differentiated intestinal-type adenocarcinoma (Lauren classification) involving proximal lesser curvature (C16.1), 5.2cm maximum dimension, with lymphovascular invasion. Surgical margins clear by 8mm.
Explanation
The good example provides specific histological details, tumor location, and margin status, which are crucial for accurate coding and treatment planning.

Need help with ICD-10 coding for Gastric Carcinoma? Ask your questions below.

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