ICD-10-CM Code C78.4

Secondary malignant neoplasm of small intestine

Version 2020 Billable Code Neoplasm Malignant Secondary

Valid for Submission

C78.4 is a billable code used to specify a medical diagnosis of secondary malignant neoplasm of small intestine. The code is valid for the year 2020 for the submission of HIPAA-covered transactions. The ICD-10-CM code C78.4 might also be used to specify conditions or terms like ampulla of vater tnm finding, malignant tumor of jejunum, malignant tumor of meckel's diverticulum, metastasis to small intestine of unknown primary, neoplasm of meckel's diverticulum, pt2: tumor invades duodenal wall , etc

The following anatomical sites found in the Table of Neoplasms apply to this code given the correct histological behavior: duodenojejunal junction ; duodenum ; ileum ; intestine, intestinal small ; intestine, intestinal small duodenum ; intestine, intestinal small ileum ; intestine, intestinal small jejunum ; etc

Short Description:Secondary malignant neoplasm of small intestine
Long Description:Secondary malignant neoplasm of small intestine


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

  • Ampulla of Vater TNM finding
  • Malignant tumor of jejunum
  • Malignant tumor of Meckel's diverticulum
  • Metastasis to small intestine of unknown primary
  • Neoplasm of Meckel's diverticulum
  • pT2: Tumor invades duodenal wall
  • Secondary malignant neoplasm of duodenum
  • Secondary malignant neoplasm of ileum
  • Secondary malignant neoplasm of jejunum
  • Secondary malignant neoplasm of Meckel's diverticulum
  • Secondary malignant neoplasm of small intestine
  • T2: Ampulla tumor invades duodenal wall
  • T3: Pancreatic tumor extends directly to any of the following: duodenum; bile duct; peripancreatic tissues
  • Tumor invades beyond pancreatic capsule to adjacent structures AND/OR organs
  • Tumor invades beyond pancreatic capsule to duodenum

Diagnostic Related Groups

The ICD-10 code C78.4 is grouped in the following groups for version MS-DRG V37.0 What are Diagnostic Related Groups?
The Diagnostic Related Groups (DRGs) are a patient classification scheme which provides a means of relating the type of patients a hospital treats. The DRGs divides all possible principal diagnoses into mutually exclusive principal diagnosis areas referred to as Major Diagnostic Categories (MDC).
applicable from 10/01/2020 through 09/30/2020.


Convert C78.4 to ICD-9

  • 197.4 - Sec malig neo sm bowel

Code Classification

  • Neoplasms (C00–D48)
    • Malignant neoplasms of ill-defined, other secondary and unspecified sites (C76-C80)
      • Secondary malignant neoplasm of resp and digestive organs (C78)

Code History

  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016
    (First year ICD-10-CM implemented into the HIPAA code set)
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020

Table of Neoplasms

The code C78.4 is included 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.

Neoplasm, neoplastic Malignant
CaInSitu Benign Uncertain
»duodenojejunal junction
»intestine, intestinal
»intestine, intestinal
»intestine, intestinal
»intestine, intestinal
»Meckel diverticulum, malignant

Information for Patients

Intestinal Cancer

Your small intestine is part of your digestive system. It is a long tube that connects your stomach to your large intestine. Intestinal cancer is rare, but eating a high-fat diet or having Crohn's disease, celiac disease, or a history of colonic polyps can increase your risk.

Possible signs of small intestine cancer include

  • Abdominal pain
  • Weight loss for no reason
  • Blood in the stool
  • A lump in the abdomen

Imaging tests that create pictures of the small intestine and the area around it can help diagnose intestinal cancer and show whether it has spread.

Surgery is the most common treatment. Additional options include chemotherapy, radiation therapy, or a combination.

NIH: National Cancer Institute

[Learn More]