ICD-10 Coding for Breast Cancer (Right)(C50.011, C50.111)
Complete ICD-10-CM coding and documentation guide for Breast Cancer (Right). Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Breast Cancer (Right)
C50.011-C50.919Primary Range
Malignant neoplasm of breast
This range includes all specific sites and laterality for breast cancer, crucial for accurate coding of right breast cancer.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| C50.011 | Malignant neoplasm of nipple and areola, right female breast | Use when the tumor is located in the nipple or areola of the right breast. |
|
| C50.111 | Malignant neoplasm of central portion of right female breast | Use when the tumor is located in the central portion of the right breast. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for right breast cancer
Essential facts and insights about Breast Cancer (Right)
Primary ICD-10-CM Codes for breast cancer right
Decision Criteria
clinical Criteria
- Presence of malignant cells in nipple biopsy
Applicable To
- Paget's disease of nipple, right breast
Excludes
- Benign neoplasm of right breast (D24.1)
Clinical Validation Requirements
- Biopsy confirming malignancy
- Imaging showing tumor in nipple/areola region
Code-Specific Risks
- Misidentifying the site as unspecified when specific location is documented.
Coding Notes
- Ensure laterality and specific site are documented to avoid unspecified coding.
C50.111 - Malignant neoplasm of central portion of right female breast
Use when the tumor is located in the central portion of the right breast.
Applicable To
- Tumor in retroareolar region
Excludes
- Benign neoplasm of central portion (D24.1)
Clinical Validation Requirements
- Biopsy confirming malignancy in central portion
- Imaging showing tumor in central breast area
Coding Notes
Document specific site and receptor status for accurate coding.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Breast Cancer (Right) to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code C50.011.
Impact
Clinical: Affects treatment decisions., Regulatory: Non-compliance with coding standards., Financial: Potential loss in reimbursement for targeted therapies.
Mitigation Strategy
Include receptor status in pathology reports., Use checklists to ensure all elements are documented.
Impact
Reimbursement: May lead to lower reimbursement rates., Compliance: Non-compliance with coding guidelines., Data Quality: Decreases accuracy of clinical data.
Mitigation Strategy
Always document and code the specific quadrant or site of the tumor.
Impact
Coding errors related to incorrect laterality documentation.
Mitigation Strategy
Implement double-check systems for laterality in documentation.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Breast Cancer (Right), with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Breast Cancer (Right)
Use these documentation templates to ensure complete and accurate documentation for Breast Cancer (Right). These templates include all required elements for proper coding and billing.
Right Breast Cancer Diagnosis
Specialty: OncologyRequired Elements
- Tumor location
- Histologic type
- Receptor status
- Stage
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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