ICD-10 Code C49.A4 | Gastrointestinal stromal tumor of large intestine Symptoms, Diagnosis, Billing

Gastrointestinal stromal tumors (GISTs) of the large intestine are rare neoplasms arising from interstitial cells of Cajal or precursor cells. These tumors can be malignant and may lead to significant morbidity. Accurate coding with ICD-10 Code C49.A4 is essential for proper diagnosis, documentation, medical billing, and public health reporting, ensuring that healthcare providers can effectively manage and treat this condition.

What is ICD-10 Code C49.A4 for Gastrointestinal stromal tumor of large intestine?

ICD-10 Code C49.A4 specifically identifies gastrointestinal stromal tumors located in the large intestine. These tumors are characterized by their potential for malignancy and can lead to complications such as gastrointestinal bleeding or obstruction. This code should be used in clinical documentation and billing when a patient is diagnosed with a GIST of the large intestine, ensuring accurate representation of the patient's condition.

ICD-10 Code C49.A4 – Clinical Definition and Explanation of Gastrointestinal stromal tumor of large intestine

Gastrointestinal stromal tumors of the large intestine are typically caused by mutations in the KIT or PDGFRA genes, leading to uncontrolled cell growth. These tumors can progress and metastasize, necessitating prompt medical attention. Early diagnosis and treatment are crucial for improving patient outcomes.

Key Clinical Features:

• Abdominal pain or discomfort
• Gastrointestinal bleeding or anemia
• Palpable abdominal mass
• Obstruction or perforation of the intestine

ICD-10 Code C49.A4 for Gastrointestinal stromal tumor of large intestine – SOAP Notes & Clinical Use

ICD-10 Code C49.A4 is utilized in SOAP notes to document the patient's symptoms, assessment findings, and treatment plans related to gastrointestinal stromal tumors of the large intestine. This code is relevant in both acute and chronic care settings, facilitating comprehensive patient management.

What Does ICD-10 Code C49.A4 for Gastrointestinal stromal tumor of large intestine Mean in SOAP Notes?

In SOAP notes, ICD-10 Code C49.A4 connects subjective patient-reported symptoms and objective clinical findings to a formal diagnosis of gastrointestinal stromal tumor of the large intestine. This ensures continuity of care, supports accurate billing, and meets EHR documentation standards.

Treatment Options for ICD-10 Code C49.A4 – Gastrointestinal stromal tumor of large intestine

Gastrointestinal stromal tumors of the large intestine require urgent medical intervention, often necessitating hospitalization for management. Treatment may include surgical resection and targeted therapies.

Antibiotic Therapy:

Supportive Care:

• Pain management with analgesics
• Nutritional support and dietary modifications
• Monitoring for complications such as bleeding or infection

Infection Control:

How to Document Symptoms of Gastrointestinal stromal tumor of large intestine (ICD-10 C49.A4) in SOAP Notes

Subjective:

• Patient reports persistent abdominal pain.
• History of gastrointestinal bleeding.
• Complaints of unexplained weight loss.
• Nausea and vomiting episodes.

Objective:

• Abdominal tenderness on palpation.
• Presence of a palpable mass in the abdomen.
• Anemia noted on complete blood count.
• Imaging shows a mass in the large intestine.

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SOAP Note Guidelines for Diagnosing Gastrointestinal stromal tumor of large intestine (ICD-10 Code C49.A4)

Assessment:

• Diagnosis: Gastrointestinal stromal tumor of large intestine, malignant.
• ICD-10 Code: C49.A4.
• Contributing factors: Genetic mutations (KIT/PDGFRA).
• Severity: Moderate to severe based on symptoms and imaging findings.

Plan:

• Refer for surgical evaluation and possible resection.
• Consider imatinib for targeted therapy if indicated.
• Educate patient on signs of complications.
• Schedule follow-up imaging to monitor tumor response.

Treatment & Plan Section for ICD-10 Code C49.A4 – Gastrointestinal stromal tumor of large intestine

• First-line treatment includes surgical resection of the tumor.
• Targeted therapy with imatinib may be indicated for unresectable tumors.
• Regular follow-up with imaging studies to monitor for recurrence.
• Patient education on dietary modifications and symptom management.

Using ICD-10 Code C49.A4 for Gastrointestinal stromal tumor of large intestine in Billing & SOAP Note Compliance

• Ensure accurate documentation of symptoms and clinical findings in SOAP notes.
• Use C49.A4 in settings where GIST diagnosis is confirmed.
• Align treatment plans with clinical guidelines to support billing.
• Include relevant CPT codes for surgical and medical interventions.

Related ICD-10 Codes Often Used with Gastrointestinal stromal tumor of large intestine

• C49.A0 – Gastrointestinal stromal tumor of unspecified site
• C49.A1 – Gastrointestinal stromal tumor of small intestine

ICD-10 Code C49.A4 in Medical Billing and Insurance for Gastrointestinal stromal tumor of large intestine

ICD-10 Code C49.A4 is critical for accurate billing in hospital, ER, or oncology settings, ensuring proper reimbursement for services rendered.

Billing Notes:

• Document all relevant clinical findings to support the use of C49.A4.
• Use this code in conjunction with surgical and medical treatment codes.
• Ensure compliance with payer-specific guidelines for GIST coding.
• Maintain thorough records of patient encounters for audit purposes.

Common CPT Pairings: