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ICD-10 Guide
ICD-10 CodesC78.80

C78.80

Billable

Secondary malignant neoplasm of unspecified digestive organ

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

Code Description

ICD-10 C78.80 is a billable code used to indicate a diagnosis of secondary malignant neoplasm of unspecified digestive organ.

Key Diagnostic Point:

C78.80 refers to secondary malignant neoplasms that have metastasized to an unspecified digestive organ. This condition typically arises from a primary cancer located elsewhere in the body, such as the breast, lung, or colon, which has spread to the digestive system. The digestive organs include the esophagus, stomach, intestines, liver, and pancreas, among others. The diagnosis of secondary malignant neoplasm indicates that the cancer is not originating in the digestive organ itself but has spread from another site. Accurate staging is crucial in managing metastatic disease, as it influences treatment options and prognosis. Palliative care considerations are also significant, as patients with metastatic cancer often require symptom management and supportive care to enhance their quality of life. The lack of specification regarding the primary site necessitates thorough documentation and clinical correlation to ensure appropriate coding and treatment planning.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Determining the primary site of cancer can be challenging.
  • Documentation must clearly indicate the metastatic nature of the disease.
  • Staging information may be incomplete or unavailable.
  • Differentiating between primary and secondary neoplasms requires careful review.

Audit Risk Factors

  • Inadequate documentation of the primary cancer site.
  • Failure to document the metastatic nature of the neoplasm.
  • Lack of staging information in the medical record.
  • Misclassification of the neoplasm as primary rather than secondary.

Specialty Focus

Medical Specialties

Oncology

Documentation Requirements

Detailed documentation of the primary cancer site, staging, and treatment plan.

Common Clinical Scenarios

Patients presenting with symptoms of gastrointestinal distress who have a known history of cancer.

Billing Considerations

Ensure that all relevant imaging and pathology reports are included to support the diagnosis.

Palliative Care

Documentation Requirements

Comprehensive documentation of symptom management strategies and patient goals of care.

Common Clinical Scenarios

Patients with advanced cancer requiring symptom relief and end-of-life care.

Billing Considerations

Focus on quality of life and symptom management rather than curative treatment.

Coding Guidelines

Inclusion Criteria

Use C78.80 When
  • According to ICD
  • 10 coding guidelines, C78
  • 80 should be used when the documentation specifies a secondary malignant neoplasm in an unspecified digestive organ
  • Coders should ensure that the primary site is documented and that the neoplasm is confirmed as metastatic

Exclusion Criteria

Do NOT use C78.80 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99214CPT Code

Established patient office visit, level 4

Clinical Scenario

Used for follow-up visits for patients with metastatic disease.

Documentation Requirements

Document the patient's history, examination findings, and treatment plan.

Specialty Considerations

Oncology specialists should ensure that all relevant cancer history is included.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of metastatic diseases, improving the accuracy of data collection and reimbursement processes. C78.80 provides a clear designation for secondary malignant neoplasms, facilitating better patient management and care planning.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of metastatic diseases, improving the accuracy of data collection and reimbursement processes. C78.80 provides a clear designation for secondary malignant neoplasms, facilitating better patient management and care planning.

Reimbursement & Billing Impact

reimbursement processes. C78.80 provides a clear designation for secondary malignant neoplasms, facilitating better patient management and care planning.

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

What is the significance of coding C78.80?

C78.80 is significant as it indicates the presence of metastatic disease in the digestive organs, which requires specific management and treatment considerations. Accurate coding ensures appropriate care and reimbursement.