C25.4
BillableMalignant neoplasm of endocrine pancreas
HCC Category Mapping
V28HCC 20 — Lung and Other Severe Cancers
0.000V24HCC 9 — Lung and Other Severe Cancers
0.973ESRDHCC 9 — Lung and Other Severe Cancers
0.000RxHCCHCC 20 — Cancer, Liver and Intrahepatic Bile Duct
0.000What This Code Means
Cancer that develops in the endocrine pancreas, the hormone-producing cells (islet cells) that regulate blood sugar and other functions.
Coding Tips
- •These are neuroendocrine tumors (NETs) and are distinct from exocrine pancreatic cancers
- •Document whether the tumor is functional (producing hormones) or non-functional for complete clinical picture
Clinical Significance
Endocrine pancreatic cancers (pancreatic neuroendocrine tumors or PNETs) are biologically and clinically distinct from the more common exocrine pancreatic adenocarcinomas. They generally have a better prognosis but can be functional (hormone-secreting) or non-functional, each requiring different management approaches. Accurate coding distinguishes these patients for appropriate resource allocation.
Documentation Requirements
- ✓Pathology confirmation of neuroendocrine tumor (NET) with grade (G1, G2, G3)
- ✓Functional status — whether the tumor produces hormones (insulin, gastrin, glucagon, VIP, somatostatin)
- ✓Ki-67 proliferation index to determine tumor grade
- ✓Current treatment status and stage
- ✓Provider statement confirming endocrine pancreas as the primary site
Use Additional Code
- code to identify any functional activity.
Commonly Confused Codes
C25.0-C25.3 — Other pancreatic cancer sites: Exocrine pancreatic cancers are far more common; verify pathology confirms neuroendocrine histologyD13.7 — Benign neoplasm of endocrine pancreas: Low-grade PNETs can be confused with benign tumors; confirm malignancyE16.1 — Other hypoglycemia: Functional insulinomas cause hypoglycemia but the underlying tumor requires a neoplasm codeC7A.094 — Malignant carcinoid tumor of foregut: Some pancreatic NETs may be classified as carcinoid tumors depending on pathology
Code Hierarchy
└C25Malignant neoplasm of pancreas└C25.4Malignant neoplasm of endocrine pancreas
└C25.4Malignant neoplasm of endocrine pancreas