ICD 10 Coding Alert

Question: How do I code GIST correctly?

Wyoming Subscriber

Answer: To find the proper diagnosis code for a gastrointestinal stromal tumor (GIST), start in the ICD-10-CM index by looking up “tumor,” says Kelly C. Loya, CPC-I, CHC, CPhT, CRMA, associate partner at Pinnacle Enterprise Risk Consulting Services LLC in Charlotte, North Carolina. Under “tumor,” locate the term “stromal” and then underneath find “gastrointestinal,” Loya says.

The index then points you to different codes based on the information available in the documentation.

If GIST is the only information you have, the default code is C49.A0 (Gastrointestinal stromal tumor, unspecified site).

If the documentation specifies uncertain behavior, you will turn to code D48.1 (Neoplasm of uncertain behavior of connective and other soft tissue). In fact, a note with D48.1 specifies it is appropriate for stromal tumors of the digestive system.

If the documentation indicates a benign GIST, use D21.4 (Benign neoplasm of connective and other soft tissue of abdomen).

Finally, for a malignant GIST, the index once again leads to C49.A0 (Gastrointestinal stromal tumor, unspecified site)  with multiple alternative 5th character options for further information to indicate the specific location of the tumor documented.