Find comprehensive information on Malignant Neoplasm of Colon, including ICD-10 codes C18-C21, clinical documentation improvement tips, and healthcare resources. Learn about colon cancer diagnosis, staging, treatment options, and pathology reports. This resource offers guidance for medical coding, documentation best practices, and optimizing EHR workflows related to malignant neoplasms of the large intestine and rectum. Explore details on adenocarcinoma of the colon, tumor markers, and the role of accurate clinical documentation in patient care.
Also known as
Malignant neoplasm of colon
Cancers affecting different parts of the colon.
Secondary malignant neoplasm
Cancer that has spread to the colon from another site.
Personal history of malignant neoplasm
Indicates a past diagnosis of colon cancer now in remission or cured.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the neoplasm specified as primary?
Yes
Is the site specified?
No
Is it metastatic?
When to use each related code
| Description |
|---|
| Colon Cancer |
| Colon Polyps |
| Diverticulitis of Colon |
Q: What are the most effective current strategies for differentiating between adenoma and malignant neoplasm of the colon using colonoscopy and histopathology findings?
A: Differentiating between adenoma and malignant neoplasm of the colon relies on a combination of colonoscopic and histopathological findings. Colonoscopically, features suggesting malignancy include irregular shape, ulceration, friability, and a sessile or depressed morphology. Histopathologically, invasion of the lamina propria or deeper structures is the defining feature of malignant neoplasm. Key characteristics examined include architectural dysplasia (loss of glandular architecture, cribriform glands, back-to-back glands), cytologic atypia (nuclear enlargement, hyperchromasia, prominent nucleoli), and the presence of a desmoplastic reaction. Immunohistochemical markers, such as Ki-67 and p53, can also be useful in assessing proliferative activity and identifying dysplastic changes. While colonoscopy provides visual cues, histopathology is the gold standard for diagnosis. Explore how integrating advanced imaging techniques like confocal laser endomicroscopy can aid in real-time tissue characterization during colonoscopy. Consider implementing a standardized reporting system for histopathology results to ensure consistent and accurate assessment of colon lesions.
Q: In patients with newly diagnosed malignant neoplasm of the colon, what are the critical factors influencing treatment selection (surgery vs. chemotherapy vs. radiation) and sequencing based on stage, molecular subtype, and patient comorbidities?
A: Treatment selection for malignant neoplasm of the colon is highly individualized and depends on a combination of factors including TNM stage, molecular subtype (e.g., microsatellite instability (MSI) status, KRAS/BRAF mutations), and patient comorbidities. For localized disease (stages I-II), surgical resection is often the primary treatment. Adjuvant chemotherapy may be recommended for patients with high-risk stage II or stage III disease. In stage IV disease, systemic chemotherapy is the mainstay of treatment, with targeted therapies like anti-EGFR antibodies considered for patients with RAS wild-type tumors. Radiation therapy can be used in rectal cancer to shrink the tumor before surgery (neoadjuvant) or to control symptoms in metastatic disease. Patient comorbidities play a significant role in determining the feasibility and tolerability of different treatment modalities. Learn more about the role of molecular profiling in personalizing therapy and optimizing treatment outcomes. Consider implementing a multidisciplinary tumor board review process to ensure comprehensive evaluation and personalized treatment planning.
Patient presents with complaints suggestive of malignant neoplasm of the colon, including rectal bleeding, changes in bowel habits (constipation, diarrhea), abdominal pain, unexplained weight loss, and fatigue. Physical examination may reveal abdominal tenderness, palpable mass, or hepatomegaly. Diagnostic workup includes colonoscopy with biopsy, which confirmed the diagnosis of adenocarcinoma of the colon. The tumor is located in the [specify location: e.g., sigmoid colon, ascending colon, transverse colon, descending colon, rectum] and is staged as [specify stage: e.g., TNM stage, Dukes' stage]. Imaging studies, such as CT scan of the abdomen and pelvis and chest x-ray, were performed to assess for metastasis. Laboratory tests, including complete blood count (CBC), comprehensive metabolic panel (CMP), carcinoembryonic antigen (CEA) levels, and liver function tests (LFTs), were conducted. The patient's medical history includes [list relevant medical history, e.g., hypertension, diabetes, prior surgeries]. Family history is significant for [mention relevant family history of colon cancer or other cancers]. Based on the clinical findings and diagnostic results, the diagnosis of colon cancer is confirmed. The patient will be referred to oncology for further management, which may include surgical resection (colectomy, hemicolectomy, low anterior resection), chemotherapy, radiation therapy, targeted therapy, or immunotherapy. Treatment plan will be determined based on the stage of the cancer, patient's overall health, and preferences. Patient education regarding colon cancer treatment options, potential side effects, and follow-up care was provided. Genetic counseling may be considered based on family history. Prognosis and survival rates were discussed. Follow-up appointment scheduled for [date]. This documentation supports ICD-10 code C18 [specify subcode based on location] for malignant neoplasm of colon and relevant CPT codes for procedures performed.