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v1.0.0
ICD-10 Guide
ICD-10 CodesC26.0

C26.0

Billable

Malignant neoplasm of intestinal tract, part unspecified

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

Code Description

ICD-10 C26.0 is a billable code used to indicate a diagnosis of malignant neoplasm of intestinal tract, part unspecified.

Key Diagnostic Point:

C26.0 refers to a malignant neoplasm located in the intestinal tract where the specific part is not identified. This code encompasses a variety of cancers that can arise in the intestines, including but not limited to adenocarcinomas, lymphomas, and carcinoid tumors. The intestinal tract includes the small intestine and large intestine, and malignancies can present with symptoms such as abdominal pain, weight loss, changes in bowel habits, and gastrointestinal bleeding. Diagnosis typically involves imaging studies, endoscopy, and biopsy to confirm malignancy. Treatment options may include surgery, chemotherapy, and radiation therapy, depending on the tumor's location, type, and stage. Accurate coding is crucial for appropriate treatment planning and reimbursement, as well as for tracking cancer incidence and outcomes in public health data.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Unspecified location can lead to ambiguity in treatment and management.
  • Requires thorough documentation to justify the unspecified nature.
  • Differentiating between types of intestinal malignancies can be complex.
  • Potential overlap with other digestive system malignancies may complicate coding.

Audit Risk Factors

  • Inadequate documentation of the specific site of malignancy.
  • Failure to provide supporting clinical information for unspecified codes.
  • Misclassification of the type of malignancy.
  • Inconsistent staging information.

Specialty Focus

Medical Specialties

Oncology

Documentation Requirements

Detailed pathology reports, imaging studies, and treatment plans.

Common Clinical Scenarios

Diagnosis of intestinal malignancy, treatment planning, and follow-up care.

Billing Considerations

Ensure that all relevant clinical findings and treatment responses are documented to support the use of C26.0.

Gastroenterology

Documentation Requirements

Endoscopy reports, biopsy results, and clinical notes on gastrointestinal symptoms.

Common Clinical Scenarios

Evaluation of patients with gastrointestinal symptoms leading to cancer diagnosis.

Billing Considerations

Documentation must clearly indicate the rationale for using an unspecified code.

Coding Guidelines

Inclusion Criteria

Use C26.0 When
  • According to ICD
  • 10 coding guidelines, C26
  • 0 should be used when the specific site of the malignant neoplasm in the intestinal tract is not documented
  • Coders must ensure that all documentation supports the use of this unspecified code and that more specific codes are not applicable

Exclusion Criteria

Do NOT use C26.0 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

44140CPT Code

Colectomy, partial

Clinical Scenario

Used when a patient undergoes surgery for an unspecified intestinal malignancy.

Documentation Requirements

Operative reports detailing the procedure and findings.

Specialty Considerations

Oncologists and surgeons must ensure that the malignancy type is documented.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more detailed coding of malignancies, but it has also introduced challenges in accurately coding unspecified conditions like C26.0. Coders must be diligent in reviewing documentation to ensure compliance with coding standards.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more detailed coding of malignancies, but it has also introduced challenges in accurately coding unspecified conditions like C26.0. Coders must be diligent in reviewing documentation to ensure compliance with coding standards.

Reimbursement & Billing Impact

reimbursement and to avoid denials.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

When should I use C26.0?

C26.0 should be used when the documentation indicates a malignant neoplasm of the intestinal tract, but the specific site is not identified. Ensure that all clinical findings support the use of this unspecified code.