Malignant Neoplasm of the Oesophagus B033

Current RMA Instruments:

Changes from previous Instruments:

ICD Coding:

• ICD-9-CM Codes: 150
• ICD-10-AM Codes: C15

Brief description

This is a primary cancer of the food pipe that connects the throat and the stomach.

Confirming the diagnosis

Diagnosis requires confirmation by histology, usually based on a biopsy performed via endoscopy.  This will also provide information on the cancer type (adenocarcinoma, squamous carcinoma or other) which is needed to apply some of the SOP factors.

The relevant medical specialist is a gastroenterologist, general surgeon or oncologist.

Additional diagnoses covered by SOP

• Adeno-, adenosquamous-, squamous-, poorly differentiated- and undifferentiated-carcinoma of the oesophagus;
• Adenoid cystic-, oat cell-, polypoid- and psuedosarcomatous- carcinoma of the oesophagus;
• Barrett's adenocarcinoma;
• Carcinoma of the oesophagus;
• Malignant melanoma of the oesophagus;

Conditions not covered by SOP

• Carcinoid tumour of the oesophagus^#
• Hodgkin's lymphoma* of the oesophagus
• Non-Hodgkin's lymphoma* of the oesophagus
• Soft tissue sarcoma* of the oesophagus
• Secondary/metastatic cancer/carcinoma involving the oesophagus (code to primary cancer site)

* another SOP applies  - the SOP has the same name unless otherwise specified

^# non-SOP condition

Clinical onset

Clinical onset will typically coincide with date of diagnosis.  The presence of prior upper gastrointestinal symptoms may not provide a basis for establishing a clinical onset, as a range of other conditions could be responsible.  Where other conditions have been excluded then more specific symptoms such as difficulty in swallowing may allow a backdating of clinical onset to a time prior to diagnosis.

Clinical worsening

The only SOP worsening factor is for inability to obtain appropriate clinical management.  This condition typically has a poor prognosis. Potential treatments (e.g. surgery) can have high risks and seriously impact quality of life.  Treatment with palliative rather than curative intent may be appropriate.  Establishing worsening due to inability to obtain appropriate clinical management will require expert medical opinion.