Oncology & Hematology Coding Alert

Question: Our oncologist has documented the diagnosis as ‘well differentiated neuroendocrine carcinoma with 2 lesions in the liver.’ Please suggest an appropriate ICD-9-CM code for this diagnosis.

New York Subscriber

Answer: For neuroendocrine tumors, you look at codes in the 209.xx range (Neuroendocrine tumors). You next need to confirm the site of the neuroendocrine tumor, determine if it is benign or malignant, and check if it is a primary or secondary lesion. You should accordingly be able to choose a code from 209.0x (Malignant carcinoid tumors of the small intestine) to 209.7x (Secondary neuroendocrine tumors).

For the diagnosis cited by your oncologist, the most appropriate code seems to be 209.29 (Malignant carcinoid tumor of other sites) if the location is the liver. The ICD-9-CM code notes also instruct to use an additional code to report the associated endocrine syndrome, such as carcinoid syndrome (259.2) if documented.