General Surgery Coding Alert

Question: The surgeon removed a mass from the patient’s jejunum. The pathology report identifies the mass as a “benign carcinoid tumor.” What is the correct diagnosis code, and how can I find the code using the ICD-10-CM book?

Tennessee Subscriber

Answer: The correct code is D3A.011 (Benign carcinoid tumor of the jejunum).

Here’s how to get there: When you know the morphology of the tumor — in this case, carcinoid — that’s the first term you should look up in the ICD-10-CM alphabetical index. The index directs you to “see Tumor, carcinoid.”

When you look that up, you’ll find the code choices divided according to tumor behavior — benign, in this case. Under benign, you’ll find the codes categorized by sites. You’re looking for “jejunum,” and when you find it, the index directs you to D3A.011.

Finally, you need to turn to the tabular list for that code to make sure it’s the correct code, and to see if there are further instructions.

For instance: Under D3A.011 you’ll see notes directing you to “Code also any associated Multiple endocrine neoplasia [MEN] syndromes (E31.2-)” and “Use additional codes to identify any associated endocrine syndrome such as: Carcinoid syndrome (E34.0).” If you have any documentation regarding those syndromes, you should also report the appropriate additional code.