Documenting Neuroendocrine Tumors – An Overview of the ICD-10 Codes

Neuroendocrine tumors (NET) are abnormal growths that begin in specialized cells called neuroendocrine cells. Neuroendocrine cells have traits similar to nerve cells and hormone-producing cells. These cells can occur anywhere in the body, but NETs are most often found in the lungs, appendix, abdomen, small intestine, adrenal glands, rectum and pancreas. Neuroendocrine tumors can be noncancerous (benign) or cancerous (malignant). The condition is rare, complex and may be difficult to diagnose. Diagnosis and treatment options for this condition depend on many factors such as the tumor’s type, location, aggressiveness, and hormone-producing capabilities; as well as whether it has metastasized. If left untreated, this condition can spread to other parts of the body and cause severe complications. Management options may include careful surveillance, surgery to remove the tumor and/or surrounding tissue, and various non-surgical therapies to shrink the tumor, or stop it from growing. Oncologists or other specialists treating this condition can rely on reputable medical billing companies to meet their claim submission tasks and thus receive correct reimbursement on time.

Reports suggest that the total incidence of neuroendocrine tumors is between five and nine million people in the United States. It is possible that these tumors are underreported because they grow slowly and do not always produce dramatic symptoms. Many of the symptoms of tumor are due to the hormones that the tumor secretes and these hormones can affect the whole body.

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Types of Neuroendocrine Tumors (NET) and Symptoms

There are different types of neuroendocrine tumors, the most common types include –

• Carcinoid tumors – These are tumors that most commonly arise in the digestive tract, lungs, appendix or thymus. In addition, they can also grow in the lymph nodes, brain, bone, gonads (ovaries and testes) or skin.
• Pancreatic neuroendocrine tumors (also called islet cell tumors) – This type of tumor typically arises in the pancreas, although they can also occur outside the pancreas.
• Pheochromocytoma – This is a rare type of NET that typically develops in the adrenal gland, but can also arise in other parts of the body.

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People with neuroendocrine tumors do not experience any specific symptoms. Or else the cause of a symptom may be another medical condition that is not cancer. Common symptoms of NETs include –

• Vomiting
• Sweating
• Rapid pulse
• Nausea
• High blood pressure
• Headache
• Fever
• Clammy skin
• Anxiety attacks
• Heart palpitations
• Painless, firm, shiny lumps on the skin that can be red, pink or blue
• Persistent pain in a specific area
• Loss of appetite or weight loss
• A cough or hoarseness that does not go away
• Thickening or lump in any part of the body
• Changes in bowel or bladder habits
• Unexplained weight gain or loss
• Persistent fever or night sweats
• High/low level of glucose in the blood

Diagnosing and Treating Neuroendocrine Tumors (NETs)

Making a correct diagnosis of this condition is often challenging. Initial diagnosis of this condition my generally begin with a detailed physical examination and evaluation of previous medical history and symptoms. Physicians may also consider conducting certain diagnostic tests to evaluate the condition correctly. The type of diagnostic tests to be conducted may depend on several factors – type of tumor, signs and symptoms, results of earlier medical tests and patient age and medical condition.

Regular and standard screening tests help to detect the condition in its earliest stages and provide the greatest chance of cure. A wide range of screening tests like X-ray, Magnetic resonance imaging (MRI), Computed tomography (CT or CAT) scan, Positron emission tomography (PET) or PET-CT scan, molecular testing of the tumor and biopsy will help detect the disease early. In addition, physicians may collect blood and urine samples to check for abnormal levels of hormones and other substances.

The type of treatment modality to be opted for this condition may depend on several factors like – the type of neuroendocrine tumor, whether the tumor is cancerous and if so the stage of cancer, possible side effects and the patient’s preferences and overall health. Top treatment options include – alpha-adrenergic blockers, chemotherapy and radiation therapy. Laproscopic surgery to remove the tumor will also be performed.

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Oncology medical billing and coding can be challenging. The diagnosis, screening tests and other procedures must be carefully documented using appropriate medical codes. Medical billing services offered by reputable service providers can help physicians use the right ICD-10 codes for their medical billing process.

ICD – 10 Codes for NETs

C7A – Malignant neuroendocrine tumors

• C7A.0 – Malignant carcinoid tumors
  • C7A.00 – Malignant carcinoid tumor of unspecified site
• C7A.01 – Malignant carcinoid tumors of the small intestine
  • C7A.010 – Malignant carcinoid tumor of the duodenum
  • C7A.011 – Malignant carcinoid tumor of the jejunum
  • C7A.012 – Malignant carcinoid tumor of the ileum
  • C7A.019 – Malignant carcinoid tumor of the small intestine, unspecified portion
• C7A.02 – Malignant carcinoid tumors of the appendix, large intestine, and rectum
  • C7A.020 – Malignant carcinoid tumor of the appendix
  • C7A.021 – Malignant carcinoid tumor of the cecum
  • C7A.022 – Malignant carcinoid tumor of the ascending colon
  • C7A.023 – Malignant carcinoid tumor of the transverse colon
  • C7A.024 – Malignant carcinoid tumor of the descending colon
  • C7A.025 – Malignant carcinoid tumor of the sigmoid colon
  • C7A.026 – Malignant carcinoid tumor of the rectum
  • C7A.029 – Malignant carcinoid tumor of the large intestine, unspecified portion
• C7A.09 – Malignant carcinoid tumors of other sites
  • C7A.090 – Malignant carcinoid tumor of the bronchus and lung
  • C7A.091 – Malignant carcinoid tumor of the thymus
  • C7A.092 – Malignant carcinoid tumor of the stomach
  • C7A.093 – Malignant carcinoid tumor of the kidney
  • C7A.094 – Malignant carcinoid tumor of the foregut, unspecified
  • C7A.095 – Malignant carcinoid tumor of the midgut, unspecified
  • C7A.096 – Malignant carcinoid tumor of the hindgut, unspecified
  • C7A.098 – Malignant carcinoid tumors of other sites
• C7A.1 – Malignant poorly differentiated neuroendocrine tumors
• C7A.8 – Other malignant neuroendocrine tumors

The symptoms of neuroendocrine tumors are wide-ranging, depending on the specific location in the body where the disease is found. A correct combination of adequate supportive care therapies may help you manage the side effects of the disease in a better manner.

Medical billing and coding for neuroendocrine tumors (NETs) can be complex, as there are several codes associated with the condition. By outsourcing medical billing and coding tasks to a reliable medical coding company (that offers the services of AAPC-certified coding specialists), healthcare practices can ensure correct and timely medical billing and claims submission.

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