2024 ICD-10-CM Diagnosis Code C25.4

Approximate Synonyms

The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:

• Carcinoma of endocrine pancreas
• Hyperinsulinemia due to malignant insulinoma
• Malignant gastrinoma of pancreas
• Malignant glucagonoma of pancreas
• Malignant insulinoma
• Malignant tumor of endocrine pancreas
• Malignant tumor of Islets of Langerhans
• Primary carcinoma of endocrine pancreas
• Primary carcinoma of pancreas
• Primary malignant gastrinoma of pancreas
• Primary malignant glucagonoma of pancreas
• Primary malignant insulinoma
• Primary malignant neoplasm of islets of Langerhans

C25.4 is grouped with Diagnostic Related Groups - MS-DRG Mapping

Diagnostic Related Groups (DRGs) are a classification system used to group together diagnosis codes for the purpose of reimbursement and healthcare management. DRGs are used to standardize the way hospitals and other providers are paid for inpatient services. In this system patients are grouped together based on their principal diagnosis in areas referred to as Major Diagnostic Categories (MDC). Once a patient is assigned a particular diagnostic category, providers receive a predetermined payment rate for the services rendered. This reimbursement rate is often fixed and is meant to cover the cost of care for that patient. Reimbursement is also affected by the relative weight of a diagnostic related group based on the severity of a patient's illness and the associated cost of care during hospitalization.

Diagnostic related groups encourage healthcare providers to focus on quality and efficiency in patient care while managing costs effectively. The diagnosis code is present in the following groups for version MS-DRG V41.0 applicable from 10/01/2023 through 09/30/2024.

MS-DRG	MS-DRG Title	MCD	Relative Weight
435	MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC	07	1.7599
436	MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC	07	1.1007
437	MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITHOUT CC/MCC	07	0.8311

The relative weight of a diagnostic related group determines the reimbursement rate based on the severity of a patient's illness and the associated cost of care during hospitalization.

Convert C25.4 to ICD-9-CM

• ICD-9-CM Code: 157.4 - Mal neo islet langerhans

Table of Neoplasms

This code is referenced in the table of neoplasms by anatomical site. For each site there are six possible code numbers according to whether the neoplasm in question is malignant, benign, in situ, of uncertain behavior, or of unspecified nature. The description of the neoplasm will often indicate which of the six columns is appropriate.

Where such descriptors are not present, the remainder of the Index should be consulted where guidance is given to the appropriate column for each morphological (histological) variety listed. However, the guidance in the Index can be overridden if one of the descriptors mentioned above is present.

Filter table of neoplasms:

Neoplasm, neoplastic	Malignant Primary	Malignant Secondary	CaInSitu	Benign	Uncertain Behavior	Unspecified Behavior
»Neoplasm, neoplastic   »insular tissue (pancreas)	C25.4	C78.89	D01.7	D13.7	D37.8	D49.0
»Neoplasm, neoplastic   »islands or islets of Langerhans	C25.4	C78.89	D01.7	D13.7	D37.8	D49.0
»Neoplasm, neoplastic   »Langerhans, islands or islets	C25.4	C78.89	D01.7	D13.7	D37.8	D49.0
»Neoplasm, neoplastic   »pancreas     »islet cells	C25.4	C78.89	D01.7	D13.7	D37.8	D49.0

Patient Education

Pancreatic Cancer

The pancreas is a gland behind your stomach and in front of your spine. It produces the juices that help break down food and the hormones that help control blood sugar levels. Pancreatic cancer usually begins in the cells that produce the juices. Some risk factors for developing pancreatic cancer include:

• Smoking
• Long-term diabetes
• Chronic pancreatitis
• Certain hereditary disorders

Pancreatic cancer is hard to catch early. It doesn't cause symptoms right away. When you do get symptoms, they are often vague or you may not notice them. They include yellowing of the skin and eyes, pain in the abdomen and back, weight loss and fatigue. Also, because the pancreas is hidden behind other organs, health care providers cannot see or feel the tumors during routine exams. Doctors use a physical exam, blood tests, imaging tests, and a biopsy to diagnose it.

Because it is often found late and it spreads quickly, pancreatic cancer can be hard to treat. Possible treatments include surgery, radiation, chemotherapy, and targeted therapy. Targeted therapy uses drugs or other substances that attack specific cancer cells with less harm to normal cells.

NIH: National Cancer Institute

[Learn More in MedlinePlus]

Pancreatic Cancer-Patient Version

Learn about pancreatic cancer risk factors, symptoms, tests to diagnose, factors affecting prognosis, staging, and treatment.
[Learn More in MedlinePlus]

Pancreatic Cancer Summary

Learn about pancreatic cancer risk factors, symptoms, tests to diagnose, factors affecting prognosis, staging, and treatment.
[Learn More in MedlinePlus]

Pancreatic Neuroendocrine Tumors (Islet Cell Tumors) Treatment (PDQ®)

Learn about pancreatic neuroendocrine tumor (islet cell tumor) risk factors, signs and symptoms, tests to diagnose, factors affecting prognosis, and treatment.
[Learn More in MedlinePlus]

Code History

• FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
• FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
• FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
• FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
• FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
• FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
• FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
• FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
• FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016. This was the first year ICD-10-CM was implemented into the HIPAA code set.