C18.5
BillableMalignant neoplasm of splenic flexure
HCC Category Mapping
V28HCC 22 — Colorectal, Bladder, and Other Cancers
0.000V24HCC 11 — Colorectal, Bladder, and Other Cancers
0.306ESRDHCC 11 — Colorectal, Bladder, and Other Cancers
0.000What This Code Means
Cancer that develops at the splenic flexure, which is the bend in the colon near the spleen where the transverse colon turns downward.
Coding Tips
- •The splenic flexure is a specific anatomical landmark; confirm documentation specifies this location rather than adjacent colon segments
- •This location may require different surgical approaches than other colon cancers
Clinical Significance
Malignant neoplasm of the splenic flexure occurs at the bend where the transverse colon turns downward to become the descending colon, near the spleen. This is one of the less common colorectal cancer sites and has unique surgical considerations due to its proximity to the spleen, left kidney, and pancreatic tail. Splenic flexure cancers may require mobilization of the spleen and distal pancreas during resection.
Documentation Requirements
- ✓Documentation specifying splenic flexure as the tumor location
- ✓Histological type and grade
- ✓Stage of disease
- ✓Relationship to spleen and adjacent structures
- ✓Colonoscopy or surgical confirmation
Commonly Confused Codes
C18.4 — Transverse colon: the splenic flexure is the bend at the end of the transverse colon, not the straight transverse segmentC18.6 — Descending colon: the descending colon begins after the splenic flexure going downwardC18.8 — Overlapping sites: use when tumor spans from transverse colon through splenic flexure into descending colon
Code Hierarchy
└C18Malignant neoplasm of colon└C18.5Malignant neoplasm of splenic flexure
└C18.5Malignant neoplasm of splenic flexure