ICD-10 Coding for Intraductal Papillary Mucinous Neoplasm(K86.8, C25.9, D13.6)
Complete ICD-10-CM coding and documentation guide for Intraductal Papillary Mucinous Neoplasm. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Intraductal Papillary Mucinous Neoplasm
K86-K87Primary Range
Diseases of the pancreas
This range includes codes for various pancreatic diseases, including IPMN.
Malignant neoplasm of pancreas
This range includes codes for malignant conditions of the pancreas, relevant for IPMN with invasive carcinoma.
Benign neoplasms of other and unspecified parts of digestive system
This range includes codes for benign neoplasms, applicable to non-invasive IPMN.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| K86.8 | Other specified diseases of pancreas | Use for non-invasive IPMN without confirmed invasion. |
|
| C25.9 | Malignant neoplasm of pancreas, unspecified | Use for IPMN with confirmed invasive adenocarcinoma. |
|
| D13.6 | Benign neoplasm of pancreas | Use for IPMN with low-grade dysplasia confirmed by biopsy. |
|
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 IPMN
Essential facts and insights about Intraductal Papillary Mucinous Neoplasm
Primary ICD-10-CM Codes for ipmn
Decision Criteria
clinical Criteria
- Non-invasive IPMN with imaging findings
Applicable To
- Non-invasive IPMN with dysplasia
Excludes
- Malignant neoplasm of pancreas (C25._)
Clinical Validation Requirements
- Imaging showing cystic lesion >5 mm
- Mucin production
- Ductal communication
Code-Specific Risks
- Risk of undercoding if invasion is present but not documented.
Coding Notes
- Ensure documentation specifies dysplasia grade and duct involvement.
C25.9 - Malignant neoplasm of pancreas, unspecified
Use for IPMN with confirmed invasive adenocarcinoma.
Applicable To
- IPMN with invasive adenocarcinoma
Excludes
- Benign neoplasm of pancreas (D13.6)
Clinical Validation Requirements
- Biopsy confirming invasion
- Elevated CA19-9 levels
Coding Notes
Document the size and type of invasion.
D13.6 - Benign neoplasm of pancreas
Use for IPMN with low-grade dysplasia confirmed by biopsy.
Applicable To
- IPMN with low-grade dysplasia
Excludes
- Malignant neoplasm of pancreas (C25._)
Clinical Validation Requirements
- Biopsy confirming low-grade dysplasia
Coding Notes
Ensure documentation specifies dysplasia grade.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Intraductal Papillary Mucinous Neoplasm to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K86.8.
Impact
Clinical: Inaccurate representation of the condition., Regulatory: Non-compliance with documentation standards., Financial: Potential loss of reimbursement.
Mitigation Strategy
Use structured documentation templates., Educate clinicians on documentation requirements.
Impact
Reimbursement: Incorrect reimbursement due to undercoding., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Use K86.8 post-resection.
Impact
Reimbursement: Potential loss of reimbursement for invasive cancer treatment., Compliance: Violation of coding standards., Data Quality: Misrepresentation of the patient's condition.
Mitigation Strategy
Code as C25._ + K86.8.
Impact
Failure to document dysplasia grade can lead to incorrect coding.
Mitigation Strategy
Implement mandatory fields in electronic health records for dysplasia grade.
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 Intraductal Papillary Mucinous Neoplasm, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Intraductal Papillary Mucinous Neoplasm
Use these documentation templates to ensure complete and accurate documentation for Intraductal Papillary Mucinous Neoplasm. These templates include all required elements for proper coding and billing.
IPMN with high-grade dysplasia
Specialty: GastroenterologyRequired Elements
- Histologic type
- Epithelial subtype
- Duct involvement
- Dysplasia grade
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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