# Coding Neuroendocrine Tumor



## buuvaneisswaran (May 7, 2019)

Neuroendocrine tumors are a rare type of tumor composed of cells that produce and secrete regulatory hormones. Tumors comprised of these cells are consequently capable of producing hormonal syndromes (e.g., carcinoid syndrome), in which the normal hormonal balance required to support body system functions is adversely affected.

Begin your search for the right code for a patient’s Neuroendocrine and Carcinoid tumor in the alphabetic index, not the Neoplasm Table..




*Neuroendocrine tumor*
 




*Neuroendocrine Tumor
**Appropriate ICD code
**ICD10 description
*When the documentation states only n_euroendocrine_ tumor and does not provide enough information (type) to assign a more specific code.
D3A.8
Neuroendocrine tumor NOS
Malignant poorly differentiated _neuroendocrine _tumors
C7A.1
Malignant poorly differentiated neuroendocrine tumors
When documentation states Malignant _neuroendocrine_ tumor/ Primary malignant neuroendocrine tumor
C7A.8
Other malignant neuroendocrine tumors 
Secondary _neuroendocrine_ carcinoma
C7B.8
Other secondary neuroendocrine tumors 
Secondary _Merkel cell_ carcinoma
C7B.1






















*If a neuroendocrine tumor (NET) spreads, it can spread to the below sites and metastasis code should be from C7B series. Carcinoid malignancies aren't going to metastasize as another type of carcinoma.*



tissues or structures near the organ where the cancer started, such as the peritoneum, the pleura or fat tissue 
lymph nodes around where the cancer started (regional lymph nodes) 
liver 
lungs 
pancreas
 
bone
 




_*Carcinoid tumors*_* are one subset of *_*tumors*_* called neuroendocrine *_*tumors*_*, usually begin in the digestive tract (stomach, appendix, small intestine, colon, rectum) or in the lungs*.
 



Carcinoid Tumor Scenario
Appropriate ICD
ICD code Description
When the documentation states only carcinoid tumor and does not provide enough information (site) to assign a more specific code.
D3A.00
Carcinoid tumor NOS - unspecified site
Malignant carcinoid tumor
C7A.00
Malignant Carcinoid tumor NOS - unspecified site. We have codes between (C7A.010 to C7A.098)
Secondary carcinoid tumor
C7B.00
Secondary Carcinoid tumor NOS - unspecified site. We have codes between (C7B.01 to C7B.09)






















Please review and let me know if there is anything that is not appropriate.


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## donna_beck15 (Apr 15, 2020)

Hi. I am stumped on coding  well - differentiated neuroendocrine carcinoma of the ileum. . One of five lymph nodes were positive for tumor.  Neuroendocrine carcinoma metastatic to intra - abdominal lymph nodes. I see that code C7B.01 is for distant lymph nodes but wouldn't this be considered regional lymph nodes? Please advise. Thank you


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