Wiki Gastrointestinal tumor DX

[Trendale]

Hello,

Do anyone know the correct way to code GIST-Gastrointestinal Tumor? The op report says Duodenal neoplasm, so I went to the pathe report and it stated GIST. It does not specify Benign or malignant. In the ICD-9 under tumor-stromal-gastrointestinal, it has 3 specifications:benign 215.5, malignant 171.5 and unc beh 238.1, next to GI, has 238.1. I am thinking to code 238.1 because the path report does not state benign or malignant.

Also, my next question, in my coding billing book, 238.1 is not listed as a covered DX. What should I do?

Thanks!

 

[mitchellde]

If it is stated as a tumor then you code it as neoplasm unspecified. Because the morphology has yet to be determined by further study. The neoplasm unspecified is a working dx and is used then until the definitive dx is returned by pathology. Neoplasm of uncertain behavior is a morphologic dx that has been determined by pathology, so that does not fit your scenario. Go to the 239 category.

 

[Trendale]

Reply

The op report stated duodenal neoplasm, whcih in that case if that was the only dx given at that time, then I would go to the neoplasm chart and code neoplasm unspecified. However, the path is in ,which states GIST, the way I understood coding tumors, was to go to tumor first before going to the neoplasm chart and follow what it tells you to do. There is a dx for GIST under tumor, it does not send me to the neoplasm chart. Please look under tumor, stromal, gastrointestinal and tell me in what case you would use this DX. After I went there, that is where I was unsure of the choices it gives you (benign .malignant or 238.1), which made me post a question.