# schwannoma



## chewri (Jul 18, 2013)

could I get help with dx code for history of schwannoma of the stomach.
thanks


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## cluke (Jul 18, 2013)

Looking up the following definition for schwannoma:  "A schwannoma (also known as an "neurilemmoma,"[1]:621 "neurinoma,"[2] "neurolemmoma,"[2] and "Schwann cell tumor"[2])" lead me to look up the term neurilemmoma.

This is turn led me to "Neoplasm, connective tissue, benign" 215.9.

Since this is a history code I think the code could be wither V12.40 or V12.49.

I look forward to anyone elses opinion on this.


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## chewri (Jul 23, 2013)

*Swannoma Tumor(stomach)*

In looking at the v12.40 or v12.49 these are both disorders of the nervous system and sense organs and what I am looking for is the stomach. Please explain why you would choose these for the stomach?


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## coachlang3 (Jul 23, 2013)

I would hope they meant V12.70 or V12.79.

History of digestive disease (NOS/NEC)


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## chewri (Jul 24, 2013)

thank you..that def makes more sense.


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## cluke (Jul 24, 2013)

Hmmm..by definition a schwanomma is a benign nerve sheath tumor, so wouldn't you code it as such, regardless of the location?


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## coachlang3 (Jul 24, 2013)

'Twas only a guess.

This is what I found about Schwannoma when I did a search:

"Neoplasm of uncertain behavior of endocrine glands and nervous system."

So in this case it is a neoplasm in the stomach.  Which one is it?  Gastric, endocrine or nervous?  Or all of the above?

V12.40 is "Unspecified disorder of nervous system and sense organs"

while
V12.49 is "Other disorders of nervous system and sense organs"  

I also found this:

Gastric schwannomas, the most common GI schwannoma, account only for 0.2% of all gastric tumors, and principally involve the submucosa and muscularis propria [4–6]. They grow slowly and exophytically and are usually asymptomatic. Because of this indolent growth pattern, as with our case, these tumors often discovered incidentally via cross-sectional imaging or endoscopy [8, 11]. If symptomatic, the most common presenting symptom is upper GI bleeding, which may be secondary to the growing submucosal mass compromising the blood supply to the overlying mucosa. The mucosa overlying the mass may then ulcerate secondary to ischemia or from a reduced tolerance to the gastric acidity [4, 10, 11].

From:
Case Reports in Surgery
Volume 2012 (2012), Article ID 280982, 5 pages
doi:10.1155/2012/280982

So really it might start as a neoplasm on a nerve I guess but it becomes a gastric tumor.  So I would still go with V12.79 since we don't know if it was benign or malignant.


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## chewri (Jul 25, 2013)

wow..who would have thought a stomach issue would be a sensory/nerve issue. 
Thank you


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