PERITONEAL MUCINOUS CARCINOMATOSIS
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ALTERNATE NAMES
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Invasive Peritoneal Mucinous Carcinomatosis; Primary Peritoneal Surface Malignancy
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DESCRIPTION
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Peritoneal
mucinous
carcinomatosis is a rare type of cancer that affects the lining of the abdominal cavity called the
peritoneum. It occurs when cancer cells from other parts of the body, such as the
appendix, colon, gall bladder, liver, rectum, or pancreas, metastasize and implant
into the lining of the peritoneum. It is a common feature of abdominal cancers that
are in the terminal stage.
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DIAGNOSTIC TESTING, PHYSICAL FINDINGS, AND
ICD-9-CM/ICD-10-CM
CODING
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Diagnostic testing:
Computed tomography (CT) scan showing thickening of the peritoneum and ascites.
Physical findings: Clinical features of this disease include:
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Gastrointestinal disorders;
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ICD-9: 197.6
ICD-10: C48.2
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PROGRESSION
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The prognosis for individuals with this disease is poor because spread of multiple
cancerous nodules from other organs to the peritoneum occurs in the late stages of
the disease.
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TREATMENT
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Peritoneal mucinous carcinomatosis is an advanced form of cancer that is treated aggressively
to prevent the cancer from spreading further. Treatment typically includes surgical
debulking followed by chemotherapy.
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SUGGESTED PROGRAMMATIC ASSESSMENT*
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Suggested MER for Evaluation:
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Clinical history and examination that describes the diagnostic features of the impairment;
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Imaging such as X-ray, CT, or magnetic resonance imaging (MRI) scan reports of the
peritoneum;
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Biopsy report of the peritoneum; and
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Tumor marker tests of blood indicating the presence of peritoneal cancer.
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Suggested Listings for
Evaluation: |
DETERMINATION
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LISTING
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REMARKS
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Meets
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13.16 B
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Any affected primary abdominal cancer listing requiring metastases beyond the regional
lymph nodes meets the criteria in listing 13.16 B. Listing level severity must be
documented.
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13.17
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Any affected primary abdominal cancer listing requiring metastases beyond the regional
lymph nodes meets the criteria in listing 13.17. Listing level severity must be documented.
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13.18
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Any affected primary abdominal cancer listing requiring metastases beyond the regional
lymph nodes meets the criteria in listing 13.18. Listing level severity must be documented.
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13.27
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Any affected primary abdominal cancer listing requiring metastases beyond the regional
lymph nodes meets the criteria in listing 13.27. Listing level severity must be documented.
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Equals
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13.15 B
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Any affected listing for sites other than primary abdominal cancers involved by primary
peritoneal carcinoma, including listing 13.15 B for men.
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13.23 E 1
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Any affected listing for sites other than primary abdominal cancers involved by primary
peritoneal carcinoma, including listing 13.23 E 1 for women.
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* Adjudicators may, at their discretion, use the Medical Evidence of Record or the
listings suggested to evaluate the claim. However, the decision to allow or deny the
claim rests with the adjudicator.
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