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ICD-10 Guide
ICD-10 CodesC16.8

C16.8

Billable

Malignant neoplasm of overlapping sites of stomach

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 C16.8 is a billable code used to indicate a diagnosis of malignant neoplasm of overlapping sites of stomach.

Key Diagnostic Point:

C16.8 refers to malignant neoplasms that occur at overlapping sites of the stomach, which can complicate diagnosis and treatment. Gastric cancer is often associated with chronic infection by Helicobacter pylori (H. pylori), a bacterium that can lead to chronic gastritis and is a significant risk factor for the development of gastric adenocarcinoma. The staging of gastric cancer is crucial for determining treatment options and prognosis, typically classified using the TNM system (Tumor, Node, Metastasis). Treatment often involves surgical intervention, such as gastrectomy, which may be total or partial depending on the extent of the disease. The complexity of coding for overlapping sites arises from the need to accurately document the specific locations involved, as well as the potential for multiple primary tumors. Accurate coding is essential for appropriate treatment planning and reimbursement, making it vital for coders to understand the nuances of gastric cancer and its associated conditions.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Multiple overlapping sites complicate documentation.
  • Need for precise staging information.
  • Association with H. pylori requires additional documentation.
  • Variability in treatment approaches (e.g., different types of gastrectomy).

Audit Risk Factors

  • Inadequate documentation of overlapping sites.
  • Failure to document staging information.
  • Lack of clarity regarding H. pylori status.
  • Inconsistent coding of gastrectomy procedures.

Specialty Focus

Medical Specialties

Oncology

Documentation Requirements

Detailed pathology reports, staging information, and treatment plans.

Common Clinical Scenarios

Diagnosis of gastric cancer, treatment planning, and follow-up care.

Billing Considerations

Ensure accurate documentation of tumor location and staging for appropriate coding.

Gastroenterology

Documentation Requirements

Endoscopy reports, biopsy results, and H. pylori testing.

Common Clinical Scenarios

Management of gastric ulcers, chronic gastritis, and screening for gastric cancer.

Billing Considerations

Document H. pylori status and any related treatments to support coding.

Coding Guidelines

Inclusion Criteria

Use C16.8 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the tumor's location, staging, and any associated conditions such as H
  • pylori infection
  • Include details from pathology reports and treatment plans

Exclusion Criteria

Do NOT use C16.8 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

43631CPT Code

Laparoscopic total gastrectomy

Clinical Scenario

Used for patients diagnosed with gastric cancer requiring total removal of the stomach.

Documentation Requirements

Operative reports detailing the procedure and findings.

Specialty Considerations

Oncology and surgery must coordinate documentation for accurate coding.

43239CPT Code

Endoscopic biopsy of stomach

Clinical Scenario

Performed to obtain tissue samples for diagnosis of gastric cancer.

Documentation Requirements

Endoscopy reports and pathology results must be included.

Specialty Considerations

Gastroenterology documentation must clearly indicate findings and biopsy results.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of gastric cancers, including overlapping sites, which enhances the accuracy of data collection and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of gastric cancers, including overlapping sites, which enhances the accuracy of data collection and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

Resources

Clinical References

  • •
    American Cancer Society - Gastric Cancer
  • •
    National Cancer Institute - Stomach Cancer Treatment

Coding & Billing References

  • •
    American Cancer Society - Gastric Cancer
  • •
    National Cancer Institute - Stomach Cancer Treatment

Frequently Asked Questions

What is the significance of H. pylori in gastric cancer?

H. pylori infection is a major risk factor for gastric cancer, leading to chronic inflammation and increasing the likelihood of malignant transformation.

How is gastric cancer staged?

Gastric cancer is staged using the TNM system, which assesses the size of the tumor, lymph node involvement, and the presence of metastasis.

What are the common treatments for gastric cancer?

Common treatments include surgical resection (gastrectomy), chemotherapy, and radiation therapy, depending on the stage and location of the cancer.