Question: 20200058

Status


Final

Category


#1:   Surgery of Primary Site
#2:   Surgery codes, NOS
#3:   Pancreas


References


Source 1:   2018 SEER Manual
pgs:  
Notes:   Appendix C, Pancreas Surgery Codes
Source 2:  
pgs:  
Notes:  


Question


Surgery of Primary Site/Surgery Codes, NOS--Pancreas:  What exactly is an extended pancreatoduodenectomy? Must the entire pancreas be resected in order to use code 70? What minimal requirements must be met to use code 70? How should a Whipple with cholecystectomy, partial omentectomy, common hepatic excision, portal vein resection, and lymphadenectomy be coded?



Discussion




Answer


According to our research, a pancreaticoduodenectomy (PD) includes an en bloc resection of the pancreatic head, the common bile duct, the gallbladder, the duodenum, the upper jejunum, the distal portion of the stomach and the adjacent lymph nodes. The extended PD procedure includes extended lymphadenectomy, extended organ resection, and extended vascular resection and reconstruction.

Code 70 could be assigned without the entire pancreas being resected.

A Whipple procedure removes the head of the pancreas, duodenum, stomach and gallbladder and part the common bile duct. The portal vein resection is probably part of the common bile duct excision. If the omentectomy was performed for treatment of this primary, record it in "Surgical Procedure of Other Site." Record the lymphadenectomy in the lymph node data items.



History




Last Updated


10/29/2020

Date Finalized


12/14/2020