PERITONEAL MUCINOUS CARCINOMATOSIS
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ALTERNATE NAMES
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Primary Peritoneal Surface Malignancy; Invasive Peritoneal Mucinous Carcinomatosis
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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: 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 people 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 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 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 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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