General Surgery Coding Alert

But watch out for overlapping sites.

Moving from ICD-9 to ICD-10 shouldn’t be too complicated when you’re coding for malignant neoplasm of the pancreatic duct. That’s because you’ll have a direct crosswalk for the diagnosis when ICD-10 goes into effect Oct. 1 this year.

One-to-One Has Exception

You should currently assign ICD-9 code 157.3 (Malignant neoplasm of pancreatic duct) when your surgeon provides services such as endoscopic retrograde cholangiopancreatography (ERCP) for a patient with that diagnosis.

Beginning Oct. 1, you’ll need to switch gears and use C25.3 (Malignant neoplasm of pancreatic duct) from the ICD-10 code set for the same condition.

Caveat: If the patient’s cancer extends to other parts of the pancreas, you’ll have a new option under ICD-10. For a malignant neoplasm of the pancreatic duct that encompasses adjacent tissue, you should instead report C25.8 (Malignant neoplasm of overlapping sites of pancreas). 

You don’t have an equivalent option under ICD-9. Instead, you currently report 157.8 (Malignant neoplasm of other specified sites of pancreas) for “Malignant neoplasm of contiguous or overlapping sites of pancreas whose point of origin cannot be determined,” according to ICD-9 instruction.