ICD-10 Coding for Peritoneal Carcinomatosis(C78.6, C48.2)
Complete ICD-10-CM coding and documentation guide for Peritoneal Carcinomatosis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Peritoneal Carcinomatosis
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| C78.6 | Secondary malignant neoplasm of retroperitoneum and peritoneum | Use when peritoneal carcinomatosis is secondary to another primary cancer. |
|
| C48.2 | Malignant neoplasm of peritoneum, unspecified | Use when primary peritoneal cancer is diagnosed without a known primary elsewhere. |
|
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 peritoneal carcinomatosis
Essential facts and insights about Peritoneal Carcinomatosis
Primary ICD-10-CM Codes for peritoneal carcinomatosis
Decision Criteria
clinical Criteria
- Presence of peritoneal nodules on imaging
documentation Criteria
- Biopsy confirming metastatic adenocarcinoma
Applicable To
- Metastatic peritoneal cancer
Excludes
- Primary peritoneal cancer (C48.2)
Clinical Validation Requirements
- Imaging showing peritoneal nodules or omental caking
- Biopsy confirming metastasis
- Documentation of primary cancer site
Code-Specific Risks
- Incorrectly coding as primary peritoneal cancer
Coding Notes
- Ensure primary cancer site is documented and coded first.
C48.2 - Malignant neoplasm of peritoneum, unspecified
Use when primary peritoneal cancer is diagnosed without a known primary elsewhere.
Applicable To
- Primary peritoneal cancer
Excludes
- Secondary peritoneal cancer (C78.6)
Clinical Validation Requirements
- Histological confirmation of primary peritoneal origin
- Immunohistochemistry consistent with primary peritoneal cancer
Coding Notes
Ensure no primary site is identified elsewhere before using this code.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Other ascites
R18.8Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Peritoneal Carcinomatosis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code C78.6.
Impact
Clinical: Misguides treatment planning., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials.
Mitigation Strategy
Cross-reference with oncology records., Ensure comprehensive history taking.
Impact
Reimbursement: Incorrect reimbursement due to misclassification., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate cancer registry data.
Mitigation Strategy
Verify and document the primary cancer site before coding.
Impact
Misclassification can lead to audit flags.
Mitigation Strategy
Thorough documentation and verification of primary cancer sites.
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 Peritoneal Carcinomatosis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Peritoneal Carcinomatosis
Use these documentation templates to ensure complete and accurate documentation for Peritoneal Carcinomatosis. These templates include all required elements for proper coding and billing.
Oncology Progress Note
Specialty: OncologyRequired Elements
- History of present illness
- Imaging findings
- Biopsy results
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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