Understanding Adenocarcinoma of the Sigmoid Colon, also known as Sigmoid Colon Cancer or Colorectal Adenocarcinoma, requires accurate clinical documentation and medical coding. This resource provides essential information for healthcare professionals on diagnosis, staging, and treatment of Adenocarcinoma of Sigmoid Colon, including relevant ICD-10 and SNOMED CT codes for optimal medical billing and healthcare data analysis. Learn about the latest clinical guidelines and best practices for managing Sigmoid Colon Cancer.
Also known as
Malignant neoplasm of sigmoid colon
Cancer specifically affecting the sigmoid colon.
Malignant neoplasm of colon
Cancer affecting various parts of the colon, including sigmoid.
Malignant neoplasms
Covers various cancers, including those of the digestive system.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the adenocarcinoma primary in the sigmoid colon?
Yes
Is there in situ involvement?
No
Code the primary site and then C78.5 for secondary malignancy of the colon
When to use each related code
| Description |
|---|
| Cancer arising from glandular cells in the sigmoid colon. |
| Cancer arising from the transverse colon. |
| Cancer in the rectum, the final section of the large intestine. |
Incorrect coding of the specific side or part of the sigmoid colon, impacting reimbursement and data accuracy. Keywords: ICD-10-CM, C18.7, laterality, coding compliance
Lack of documentation specifying the histology of the adenocarcinoma, leading to undercoding and lost revenue. Keywords: SNOMED CT, M-8140/3, adenocarcinoma, CDI queries
Insufficient documentation of the cancer stage, impacting treatment planning and accurate quality reporting. Keywords: TNM staging, AJCC, abstracting, healthcare compliance
Q: What are the most effective current treatment strategies for locally advanced adenocarcinoma of the sigmoid colon in elderly patients?
A: Treatment for locally advanced adenocarcinoma of the sigmoid colon in elderly patients requires careful consideration of patient comorbidities and performance status. Generally, the approach mirrors that of younger patients, involving multidisciplinary management. Surgical resection remains the cornerstone of treatment, aiming for complete tumor removal with adequate margins. For T3/T4 tumors or node-positive disease, adjuvant chemotherapy with regimens such as FOLFOX (5-fluorouracil, leucovorin, oxaliplatin) or CAPOX (capecitabine, oxaliplatin) may be considered, often with dose adjustments based on patient tolerance. Radiation therapy can be utilized in select cases, particularly for locally advanced rectal tumors or those with positive margins post-surgery. Neoadjuvant chemoradiation followed by surgery and adjuvant chemotherapy is sometimes considered for locally advanced rectal tumors to improve resectability. Targeted therapies such as bevacizumab or cetuximab may be incorporated depending on molecular profiling (KRAS, NRAS, BRAF) and patient suitability. Ultimately, treatment decisions must be individualized through shared decision-making, balancing treatment efficacy with potential toxicity in this vulnerable population. Explore how geriatric oncology principles can further refine treatment strategies for these patients.
Q: How can I differentiate between diverticulitis and sigmoid colon cancer based on CT scan findings, and what are the key radiological features to look for?
A: Differentiating diverticulitis and sigmoid colon cancer on CT can be challenging, as both can present with bowel wall thickening and pericolic inflammation. Key features suggestive of sigmoid colon cancer include a focal, irregular mass, asymmetric bowel wall thickening, and pericolonic fat stranding with a "shouldering" effect adjacent to the mass. Diverticulitis typically presents with more diffuse, concentric bowel wall thickening, associated with diverticula, and inflammation often confined to the pericolic fat surrounding the diverticula. The presence of lymphadenopathy, distant metastases, or bowel obstruction favors malignancy. However, overlapping imaging features can occur, requiring careful consideration of clinical presentation, laboratory findings (e.g., CEA levels), and potentially further investigations such as colonoscopy with biopsy for definitive diagnosis. Consider implementing a standardized radiological reporting template for improved diagnostic accuracy. Learn more about the utility of advanced imaging techniques, such as MRI or PET/CT, in challenging cases.
Patient presents with complaints consistent with possible sigmoid colon cancer, including altered bowel habits (constipation, diarrhea, or narrowing of stool), rectal bleeding or blood in stool, abdominal pain or discomfort (cramping, bloating, or gas), unexplained weight loss, fatigue, and anemia. Physical examination may reveal palpable abdominal mass, tenderness in the left lower quadrant, or signs of anemia. Differential diagnosis includes diverticulitis, inflammatory bowel disease (Crohn's disease, ulcerative colitis), irritable bowel syndrome, and hemorrhoids. Diagnostic workup includes colonoscopy with biopsy, which revealed adenocarcinoma of the sigmoid colon. Staging will be determined with CT scans of the abdomen and pelvis, chest x-ray, and possibly PET scan to assess for metastasis. Carcinoembryonic antigen (CEA) levels will be monitored. Treatment plan for this colorectal adenocarcinoma may involve surgical resection (sigmoidectomy, partial colectomy, or low anterior resection), potentially with lymph node dissection. Adjuvant chemotherapy or radiation therapy may be recommended based on staging and molecular profiling of the tumor. Patient education regarding bowel preparation, surgical risks, and post-operative care, including ostomy care if applicable, is crucial. Referral to oncology and potentially gastroenterology for ongoing management will be made. Follow-up colonoscopies and CEA monitoring will be scheduled for surveillance of recurrence. ICD-10 code C18.7 will be used for malignant neoplasm of the sigmoid colon.