C78.4
BillableSecondary malignant neoplasm of small intestine
HCC Category Mapping
V28HCC 17 — Metastatic Cancer and Acute Leukemia
0.368V24HCC 8 — Metastatic Cancer and Acute Leukemia
2.484ESRDHCC 8 — Metastatic Cancer and Acute Leukemia
0.000RxHCCHCC 20 — Cancer, Liver and Intrahepatic Bile Duct
0.000What This Code Means
Cancer that has spread to the small intestine from a primary cancer located elsewhere in the body.
Coding Tips
- •This code indicates metastatic disease to the small intestine; always identify and code the primary cancer site
- •Distinguish from primary small intestine cancer (C17.x codes) by confirming the cancer originated elsewhere
Clinical Significance
Secondary malignant neoplasm of the small intestine indicates metastatic cancer has spread to the small bowel. Small intestinal metastases are relatively uncommon and may present with obstruction, bleeding, or perforation. This finding confirms advanced-stage disease and impacts treatment strategy significantly, often necessitating surgical intervention for complications.
Documentation Requirements
- ✓Primary cancer site documented and coded separately
- ✓Confirmation that the small intestine involvement is metastatic, not primary
- ✓Specific segment of small intestine if documented — duodenum, jejunum, or ileum
- ✓Imaging or surgical/pathological confirmation
- ✓Complications such as obstruction, perforation, or hemorrhage requiring additional codes
Commonly Confused Codes
C17.0-C17.9 — Primary malignant neoplasm of small intestine; must distinguish primary from secondary small bowel cancerC78.5 — Secondary malignant neoplasm of large intestine and rectum; large and small intestine metastases use different codesC78.6 — Secondary malignant neoplasm of peritoneum; peritoneal carcinomatosis may involve bowel serosa but is coded differentlyC7A.010-C7A.019 — Malignant carcinoid tumors of small intestine; carcinoid tumors are primary neuroendocrine neoplasms, not secondary
Code Hierarchy
└C78Secondary malignant neoplasm of respiratory and digestive organs└C78.4Secondary malignant neoplasm of small intestine
└C78.4Secondary malignant neoplasm of small intestine