Gastrointestinal carcinoid tumor is a slow-growing tumor that forms in the neuroendocrine cells in the GI tractlining. Knowledge of ICD-10 coding guidelines will help with accurate documentation.

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How to Document
GI Carcinoid Tumors
Using ICD-10 Codes
Gastrointestinal carcinoid tumor
is a slow-growing tumor that
forms in the neuroendocrine cells
in the GI tractlining. Knowledge
of ICD-10 coding guidelines will
help with accurate documentation.
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A Gastrointestinal (GI) carcinoid tumor is a type of cancer that forms in the
neuroendocrine cells in the gastrointestinal (GI) tract lining. The GI tract
includes the stomach, colon, rectum, small intestine and other organs. GI
carcinoid tumors are rare and most grow very slowly. In most cases, these
tumors form in the rectum, small intestine, or appendix. Reports suggest
that an estimated 12,000 people are diagnosed with a carcinoid tumor each
year in the United States (2016 statistics). People who have a family history
of multiple endocrine neoplasia type 1 (MEN1) syndrome or
neurofibromatosis type 1 (NF1) syndrome have a higher risk of suffering GI
carcinoid tumors. In order to reduce the increasing tumor rates, healthcare
practices must correctly diagnose, conduct screening and treat patients.
Coding and sequencing for carcinoid tumors depends on the physician
documentation in the medical record and application of the official coding
guidelines for inpatient care. A combined effort from the part of clinicians
and medical coding companies is crucial to ensure accurate
documentation and optimal reimbursement.
What are the Signs and Symptoms?
Generally, GI carcinoid tumors do not cause any specific signs and
symptoms in the early stages of the disease process. However, when they
do occur, these signs and symptoms are usually vague and depend on the
location of the tumor. Symptoms include –
 Chest pain
 Bowel obstruction
 Wheezing
 Shortness of breath
 Rectal pain and bleeding
 Diarrhea
 Redness or a feeling of warmth in your face and neck (skin flushing)
 Weight gain (particularly around the midsection and upper back)
 Pink or purple marks on the skin that look like stretch marks
 Recurrent pneumonia
Diagnosis and Documentation of GI Carcinoid Tumors
Diagnosing a small carcinoid tumor that’s not causing carcinoid symptoms is
difficult. Generally, these symptoms are found while doing a surgery or

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through imaging studies performed for other health issues. For instance,
some tumors are found when a healthcare provider removes an appendix.
In some cases, if a tumor is suspected and patients have symptoms, various
blood and urine tests are conducted to detect abnormal amounts of
hormones and other substances (peptides) produced by the tumor, including
chromogranin A (a protein commonly found in many carcinoid tumors) and
5HIAA (a byproduct of serotonin found in the urine). In addition, several
diagnostic imaging tests such as – MRI, Triphasic CT Scanning, OctreoScan,
Endoscopic ultrasound (EUS), Colonoscopy, PET scan (positron emission
tomography scan) and MIBG Scintiscan may be performed to confirm the
diagnosis, and to determine the exact location and size of the tumor,
whether it has spread to other organs, and whether it can be surgically
removed.
Diagnosing the condition correctly and submitting proper clinical
documentation is crucial for promoting error-free billing practices. A
professional medical billing and coding company can ensure this. ICD-10
codes for screening gastrointestinal (GI) carcinoid tumor include –
C7A.0 Malignant carcinoid tumors
 C7A.00 - Malignant carcinoid tumor of unspecified site
C7A.01 - Malignant carcinoid tumors of the small intestine
 C7A.010- Malignant carcinoid tumor of the duodenum
 C7A.011 - Malignant carcinoid tumor of the jejunum
 C7A.012 - Malignant carcinoid tumor of the ileum
 C7A.019 - Malignant carcinoid tumor of the small intestine, unspecified
portion
C7A.02 - Malignant carcinoid tumors of the appendix, large intestine,
and rectum
 C7A.020 - Malignant carcinoid tumor of the appendix
 C7A.021 - Malignant carcinoid tumor of the cecum
 C7A.022 - Malignant carcinoid tumor of the ascending colon
 C7A.023 - Malignant carcinoid tumor of the transverse colon
 C7A.024 - Malignant carcinoid tumor of the descending colon
 C7A.025 - Malignant carcinoid tumor of the sigmoid colon

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 C7A.026 - Malignant carcinoid tumor of the rectum
 C7A.029 - Malignant carcinoid tumor of the large intestine, unspecified
portion
C7A.09 - Malignant carcinoid tumors of other sites
 C7A.090 - Malignant carcinoid tumor of the bronchus and lung
 C7A.091 - Malignant carcinoid tumor of the thymus
 C7A.092 - Malignant carcinoid tumor of the stomach
 C7A.093 - Malignant carcinoid tumor of the kidney
 C7A.094 - Malignant carcinoid tumor of the foregut, unspecified
 C7A.095 - Malignant carcinoid tumor of the midgut, unspecified
 C7A.096 - Malignant carcinoid tumor of the hindgut, unspecified
 C7A.098 - Malignant carcinoid tumors of other sites
C7A.1 - Malignant poorly differentiated neuroendocrine tumors
C7A.8 - Other malignant neuroendocrine tumors
C7B - Secondary neuroendocrine tumors
 C7B.0 - Secondary carcinoid tumors
 C7B.00 - Secondary carcinoid tumors, unspecified site
Like all types of tumors, early detection is crucial when it comes to
successful treatment. If found in its early stages, the disease can be
contained, and the tumor treated effectively. A good provider of medical
billing and coding services can help providers submit clean medical
claims, avoid claim denials and receive optimal reimbursement.