Pancreatic Cancer ICD-10 Coding

Pancreatic Cancer ICD-10 Coding

To properly code pancreatic cancer, physicians must follow the Official Coding Guidelines. These guidelines apply to inpatient care. For more information, see the American Medical Association and AHA Coding Clinic. These resources provide guidelines for both CPT Assistant and ICD-9-CM. These guidelines also require accurate documentation of the diagnosis and treatment. The following article will discuss the details of pancreatic cancer coding.

ICD-10 code C25.9

If you diagnose pancreatic cancer, you will use the ICD-10 code C25.9. This code is valid for medical billing and claims filed after October 1, 2015. This diagnosis is specific to pancreatic cancer and is also considered a billable diagnosis in HIPAA-covered transactions.

Neoplasms that affect a particular body system, such as the pancreas, may be found in separate chapters for the organ or system. In the ICD-10-CM, the most common neoplasms are included in chapter 2. For proper coding, the neoplasm's histology must be known. Secondary locations must be determined, especially for malignant tumours.


The coding process for pancreatic cancer depends on the medical record documentation from the physician and the application of Official Coding Guidelines for inpatient care. Those with pancreatic cancer should refer to a reference book for coding and billing information, including the American Medical Association's CPT Assistant and the AHA Coding Clinic. These books contain detailed information about the symptoms of pancreatic cancer and the codes for different stages of the disease.

This study aimed to determine whether ICD-10 codes of pancreatic cancer are reliable enough to improve the diagnosis and prognosis of the disease. It used the claims data from the Korean National Health Insurance (NHI) program from 2003 to 2016 at Seoul National University Bundang Hospital. ICD-10 codes for pancreatic cancer were assigned to the patients based on their clinical features. Those who have a family history of pancreatic cancer should report it as a personal history of the disease.


The ICD-10-CM classification system for cancer includes codes for all malignant and benign neoplasms. Depending on the type of tumour, a different code may be appropriate for the patient's condition. ICD-10-CM codes can also indicate the primary site of cancer, enabling more accurate diagnosis and billing. The American version of the code system went into effect on October 1, 2021.

Currently, ICD-10 codes for pancreatic cancer are acceptable for use in extensive population cohort studies, enhancing diagnostic accuracy. This condition presents a poor prognosis because most patients are diagnosed at an advanced stage when cancer has invaded nearby arteries and is intractable to conventional treatment. Because of these factors, accurate diagnosis of pancreatic cancer remains a challenge despite the widespread use of EUS-FNA. Consequently, most patients are diagnosed based on their clinical presentation, and this means that it is essential to establish a solid diagnosis before undergoing any treatment.


The ICD-10 code for pancreatic cancer is acceptable in population-based large-cohort studies. It increases diagnostic accuracy by identifying patients by ICD-10 regulation. Unfortunately, pancreatic cancer has a poor prognosis, with most patients being diagnosed at advanced stages when the tumours have already invaded adjacent arteries and are inoperable. Despite the growing use of EUS-FNA, accurate diagnosis of pancreatic cancer is still challenging. Most patients are diagnosed based on their clinical features.

The ICD-10 code for pancreatic cancer depends on the diagnosis and the physician's documentation in the medical record. It is also dependent upon the patient's personal history of malignant neoplasms. Fortunately, the ICD-10 codes will remain with the patient for the rest of their lives. This greatly benefits patients who may not otherwise receive treatment for pancreatic cancer.