Neoplasms (C00-D49)

Note:
Functional activity
All neoplasms are classified in this chapter, whether they are functionally active or not. An additional code from Chapter 4 may be used, to identify functional activity associated with any neoplasm.
Morphology [Histology]
Chapter 2 classifies neoplasms primarily by site (topography), with broad groupings for behavior, malignant, in situ, benign, etc. The Table of Neoplasms should be used to identify the correct topography code. In a few cases, such as for malignant melanoma and certain neuroendocrine tumors, the morphology (histologic type) is included in the category and codes.
Primary malignant neoplasms overlapping site boundaries
A primary malignant neoplasm that overlaps two or more contiguous (next to each other) sites should be classified to the subcategory/code .8 ('overlapping lesion'), unless the combination is specifically indexed elsewhere. For multiple neoplasms of the same site that are not contiguous, such as tumors in different quadrants of the same breast, codes for each site should be assigned.
Malignant neoplasm of ectopic tissue
Malignant neoplasms of ectopic tissue are to be coded to the site mentioned, e.g., ectopic pancreatic malignant neoplasms are coded to pancreas, unspecified (C25.9).

Malignant neoplasms of digestive organs (C15-C26)

Excludes 1:
Kaposi's sarcoma of gastrointestinal sites (C46.4)
Excludes 2:
gastrointestinal stromal tumors (C49.A-)
C15 Malignant neoplasm of esophagus [+]
Use additional code to identify:
Use additional alcohol abuse and dependence (F10.-)
C16 Malignant neoplasm of stomach [+]
Use additional code to identify:
Use additional alcohol abuse and dependence (F10.-)
Excludes 2: malignant carcinoid tumor of the stomach (C7A.092)
C17 Malignant neoplasm of small intestine [+]
Excludes 1: malignant carcinoid tumors of the small intestine (C7A.01)
C18 Malignant neoplasm of colon [+]
Excludes 1: malignant carcinoid tumors of the colon (C7A.02-)
C19 Malignant neoplasm of rectosigmoid junction
Malignant neoplasm of colon with rectum
Malignant neoplasm of rectosigmoid (colon)
Excludes 1: malignant carcinoid tumors of the colon (C7A.02-)
C20 Malignant neoplasm of rectum
Malignant neoplasm of rectal ampulla
Excludes 1: malignant carcinoid tumor of the rectum (C7A.026)
C21 Malignant neoplasm of anus and anal canal [+]
Excludes 2: malignant carcinoid tumors of the colon (C7A.02-)
malignant melanoma of anal margin (C43.51)
malignant melanoma of anal skin (C43.51)
malignant melanoma of perianal skin (C43.51)
other and unspecified malignant neoplasm of anal margin (C44.500, C44.510, C44.520, C44.590)
other and unspecified malignant neoplasm of anal skin (C44.500, C44.510, C44.520, C44.590)
other and unspecified malignant neoplasm of perianal skin (C44.500, C44.510, C44.520, C44.590)
C22 Malignant neoplasm of liver and intrahepatic bile ducts [+]
Use additional code to identify:
Use additional alcohol abuse and dependence (F10.-)
Use additional hepatitis B (B16.-, B18.0-B18.1)
Use additional hepatitis C (B17.1-, B18.2)
Excludes 1: malignant neoplasm of biliary tract NOS (C24.9)
secondary malignant neoplasm of liver and intrahepatic bile duct (C78.7)
C23 Malignant neoplasm of gallbladder
C24 Malignant neoplasm of other and unspecified parts of biliary tract [+]
Excludes 1: malignant neoplasm of intrahepatic bile duct (C22.1)
C25 Malignant neoplasm of pancreas [+]
Code also if applicable exocrine pancreatic insufficiency (K86.81)
Use additional code to identify:
Use additional alcohol abuse and dependence (F10.-)
C26 Malignant neoplasm of other and ill-defined digestive organs [+]
Excludes 1: malignant neoplasm of peritoneum and retroperitoneum (C48.-)

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