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ICD-10 Guide
ICD-10 CodesE34.00

E34.00

Billable

Carcinoid syndrome, unspecified

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

Code Description

ICD-10 E34.00 is a billable code used to indicate a diagnosis of carcinoid syndrome, unspecified.

Key Diagnostic Point:

Carcinoid syndrome is a complex of symptoms that arise from the secretion of serotonin and other vasoactive substances by neuroendocrine tumors, primarily carcinoid tumors. These tumors are most commonly found in the gastrointestinal tract, particularly the small intestine, but can also occur in the lungs and other sites. The syndrome is characterized by flushing, diarrhea, wheezing, and abdominal pain. Patients may also experience cardiac complications, such as carcinoid heart disease, which can lead to valvular dysfunction. The symptoms can vary widely among patients, and the diagnosis often requires a combination of clinical evaluation, biochemical tests (such as serum serotonin levels), and imaging studies. The unspecified designation indicates that the specific type or site of the carcinoid tumor has not been determined, which can complicate management and treatment strategies. Understanding the underlying pathophysiology is crucial for effective treatment, which may include surgical resection, somatostatin analogs, and targeted therapies.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in symptom presentation among patients
  • Need for comprehensive diagnostic testing
  • Potential for multiple tumor sites
  • Differential diagnosis with other gastrointestinal disorders

Audit Risk Factors

  • Inadequate documentation of symptoms
  • Failure to specify tumor location
  • Misinterpretation of related conditions
  • Lack of supporting lab results

Specialty Focus

Medical Specialties

Oncology

Documentation Requirements

Detailed documentation of tumor type, location, and treatment plan.

Common Clinical Scenarios

Patients presenting with gastrointestinal symptoms and a known history of neuroendocrine tumors.

Billing Considerations

Ensure that all relevant imaging and lab results are included in the documentation.

Endocrinology

Documentation Requirements

Comprehensive hormonal assessment and symptom tracking.

Common Clinical Scenarios

Patients with flushing and diarrhea who have elevated serotonin levels.

Billing Considerations

Document any hormonal therapies or interventions that may affect symptom management.

Coding Guidelines

Inclusion Criteria

Use E34.00 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the condition's specifics
  • Include any relevant lab results and imaging studies to support the diagnosis

Exclusion Criteria

Do NOT use E34.00 When
  • Exclude conditions that may mimic carcinoid syndrome unless they are specifically documented

Related ICD-10 Codes

Related CPT Codes

88305CPT Code

Pathology examination of tumor tissue

Clinical Scenario

Used when a biopsy is performed to confirm the presence of a carcinoid tumor.

Documentation Requirements

Pathology report must be included in the patient's medical record.

Specialty Considerations

Oncology specialists should ensure that all relevant tumor characteristics are documented.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of carcinoid syndrome, improving the accuracy of data collection and reimbursement processes. The ability to specify tumor types and associated conditions enhances clinical management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of carcinoid syndrome, improving the accuracy of data collection and reimbursement processes. The ability to specify tumor types and associated conditions enhances clinical management.

Reimbursement & Billing Impact

reimbursement processes. The ability to specify tumor types and associated conditions enhances clinical management.

Resources

Clinical References

  • •
    American Cancer Society - Carcinoid Tumors

Coding & Billing References

  • •
    American Cancer Society - Carcinoid Tumors

Frequently Asked Questions

What are the common symptoms of carcinoid syndrome?

Common symptoms include flushing, diarrhea, wheezing, and abdominal pain, often due to the secretion of serotonin and other vasoactive substances by carcinoid tumors.