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ICD-10 Guide
ICD-10 CodesC25.8

C25.8

Billable

Malignant neoplasm of overlapping sites of pancreas

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

Code Description

ICD-10 C25.8 is a billable code used to indicate a diagnosis of malignant neoplasm of overlapping sites of pancreas.

Key Diagnostic Point:

C25.8 refers to malignant neoplasms that arise from overlapping sites of the pancreas, which can complicate diagnosis and treatment. Pancreatic cancer is often diagnosed at an advanced stage due to its asymptomatic nature in early stages. The pancreas is a complex organ with various functions, and tumors can develop in different regions, making it challenging to pinpoint the exact site of origin. Staging pancreatic cancer is particularly difficult, as it often involves local invasion and metastasis by the time of diagnosis. The CA 19-9 tumor marker is frequently used in the management of pancreatic cancer, although it is not specific to the disease and can be elevated in other conditions. The prognosis for patients with pancreatic cancer is generally poor, with a five-year survival rate of less than 10%, largely due to late-stage diagnosis and aggressive tumor behavior. Treatment options may include surgery, chemotherapy, and radiation therapy, but the effectiveness varies significantly based on the stage at diagnosis.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Overlapping sites complicate precise coding.
  • Staging difficulties due to late diagnosis.
  • Variability in tumor markers like CA 19-9.
  • Need for detailed documentation of tumor location.

Audit Risk Factors

  • Inadequate documentation of tumor location.
  • Failure to document staging details.
  • Misinterpretation of CA 19-9 levels.
  • Inconsistent coding of overlapping sites.

Specialty Focus

Medical Specialties

Oncology

Documentation Requirements

Detailed pathology reports, imaging studies, and treatment plans.

Common Clinical Scenarios

Diagnosis and management of pancreatic tumors, staging evaluations.

Billing Considerations

Ensure accurate documentation of tumor markers and staging to support coding.

Gastroenterology

Documentation Requirements

Endoscopic findings, biopsy results, and imaging studies.

Common Clinical Scenarios

Evaluation of pancreatic masses, management of complications.

Billing Considerations

Document any overlapping site involvement and associated symptoms.

Coding Guidelines

Inclusion Criteria

Use C25.8 When
  • Follow the official ICD
  • CM coding guidelines for neoplasms, ensuring accurate documentation of the site and behavior of the tumor
  • Include staging information when available, and use additional codes for associated conditions

Exclusion Criteria

Do NOT use C25.8 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

47563CPT Code

Laparoscopic cholecystectomy

Clinical Scenario

Often performed in patients with pancreatic cancer to manage biliary obstruction.

Documentation Requirements

Operative reports detailing the procedure and findings.

Specialty Considerations

Oncologists and gastroenterologists should ensure clear linkage between the procedure and the diagnosis.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of pancreatic cancers, including overlapping sites, which aids in better tracking and management of the disease.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of pancreatic cancers, including overlapping sites, which aids in better tracking and management of the disease.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of pancreatic cancers, including overlapping sites, which aids in better tracking and management of the disease.

Resources

Clinical References

  • •
    American Cancer Society - Pancreatic Cancer

Coding & Billing References

  • •
    American Cancer Society - Pancreatic Cancer

Frequently Asked Questions

What is the significance of CA 19-9 in pancreatic cancer?

CA 19-9 is a tumor marker that can help in monitoring treatment response and disease progression in pancreatic cancer, but it is not specific and can be elevated in other conditions.