Wiki Regional Lymph Nodes

[annettebec]

What ICD10 would you assign for the Regional Lymph nodes?
Pancreas, duodenum, and distal stomach, whipple with en bloc SMV resection:
· Residual invasive adenocarcinoma, poorly-differentiated
· Tumor extends into superior mesenteric vein, duodenal wall, and pyloric sphincter
· Size: 4.5 cm
· Margins uninvolved by dysplasia or carcinoma
· Perineural and lymphovascular invasion
· Treatment response: >95% tumor viability (poor response, score 3)
· Metastatic carcinoma in three of twenty-four lymph nodes (3/24)

Synoptic Report:
REGIONAL LYMPH NODES
Regional Lymph Node Status Tumor present in regional lymph node(s)
Number of Lymph Nodes with Tumor 3
Number of Lymph Nodes Examined 25

Thank you

 

[danachock]

Hello annettebec,
It would be C77.2 for the regional lymph nodes.
The reason I state this (rationale) is because I know that reviewing the Index, next the Neoplasm Table and validating this diagnosis code within the Tabular.
Our Neoplasm Table states for lymph nodes for the "gastric", "intestinal", and "pancreatic" would receive C77.2.
C77.2 is Secondary and unspecified malignant neoplasm of intra-abdominal lymph nodes and reviewing the locations this would be my diagnosis assignment.
The patient has adenocarcinoma, it states that metastatic carcinoma in 3 or the 24 lymph nodes.
The Synoptic report is a little condensed versus what I normally see but I provided exactly how I arrived with this diagnosis assignment.
If I missed anything or if you have additional questions, please let me know okay.
Thank you for listening,
Dana

 

[annettebec]

Thank you for your help!!