2025 ICD-10-CM code C25.9
(Active) Effective Date: N/A Neoplasms - Malignant neoplasms of digestive organs (C15-C26) Chapter 2: Neoplasms (C00-D49) Feed
Malignant neoplasm of pancreas, unspecified.
Medical necessity for procedures related to pancreatic cancer depends on the stage, location, and patient's overall health.Detailed clinical documentation supporting the need for diagnostic tests, treatments, and other services is essential.
Clinicians should document the specific part of the pancreas affected by the malignancy whenever possible to allow for more specific coding.If the documentation lacks this level of detail, C25.9 is the appropriate code.
In simple words: This code refers to cancer in the pancreas, but the specific location within the pancreas isn't specified in the medical record.
Malignant neoplasm of pancreas, unspecified. This code is used when the documentation does not specify the part of the pancreas affected by the malignant neoplasm.
Example 1: A patient presents with symptoms suggestive of pancreatic cancer, but imaging studies do not definitively identify the primary site within the pancreas., A pathology report diagnoses pancreatic adenocarcinoma without specifying the location of the tumor., A patient's death certificate lists "pancreatic cancer" as the cause of death, with no further details.
Documentation should include details of the diagnosis, including imaging and pathology reports, to identify the affected part of the pancreas. If no specific site is identified, the documentation should explicitly state "pancreas, unspecified".
** This code is for malignant neoplasms of the pancreas where the specific site is not documented. It's important to code to the highest level of specificity possible, and clinicians should strive to provide detailed documentation to allow for this.Refer to the iFrameAI product if you require a higher level of precision and clinical validation concerning medical coding and associated regulatory guidelines.
- Payment Status: Active
- Specialties:Oncology, Gastroenterology, General Surgery
- Place of Service:Inpatient Hospital, On Campus-Outpatient Hospital, Office