# Spindle cell neoplasm



## 0913@70 (May 22, 2014)

HI, i would appropriate if somebody can help me with this.

The pathology states Spindle cell neoplasm


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## 0913@70 (May 22, 2014)

sorry i wasn't done 


The pathology report states, Mass of antrum of stomach: Spindle cell neoplasm, CD117 positive, S100 negative, SMA  weekly and focally positive, KI-67 Less than 2%

final dx KIT CD117 positive, margins negative


Can you tell me if this is dx of cancer or tumor?

Thank you


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## mitchellde (May 22, 2014)

You need a code for malignant neoplasm of stomach, Antrum, primary site.


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## 0913@70 (May 22, 2014)

Thank you so much for your response

The surgeon billed 43611, dx code 239.0

The CPT code is correct , but the dx code should be malignant, am i correct?


Thank you


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## mitchellde (May 22, 2014)

Yes it is not unspecified as you have a path report.  Unspecified would be used if the provider performed a preliminary diagnostic study and rendered a diagnosis of tumor or abnormal growth.


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## 0913@70 (May 23, 2014)

Thank you so much for your help!


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## bbooks (May 28, 2014)

I asked one of my pathologists about this one. He said that based on the limited information given, one could not classify this as malignant. He thought a better interpretation would be as unspecified.

Here is a link for gastrointestinal stromal tumors (GIST): http://www.pathologyoutlines.com/topic/stomachGIST.html

Before coding this as malignant, I would check with the pathologist who interpreted it. There may be additional information from the case that would clarify the diagnosis.

I am reluctant to use a code for malignancy unless it is very clear.


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## mitchellde (May 28, 2014)

From Dr. Lewis :
Most SpCC are overtly malignant, and the differential diagnosis then includes a number of different malignant spindle cell neoplasms. 
Which is why I chose malignant neoplasm.


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