ICD-10 Coding for Ductal Carcinoma(C50.911, D05.10)
Complete ICD-10-CM coding and documentation guide for Ductal Carcinoma. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Ductal Carcinoma
C50.0-C50.9Primary Range
Malignant neoplasm of breast
This range includes codes for malignant neoplasms of the breast, including ductal carcinoma.
Carcinoma in situ of breast
This range includes codes for carcinoma in situ of the breast, relevant for DCIS.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| C50.911 | Malignant neoplasm of unspecified site of right female breast | Use when the specific site within the right breast is not documented. |
|
| D05.10 | Carcinoma in situ of unspecified breast | Use when DCIS is confirmed without specification of laterality. |
|
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 ductal carcinoma
Essential facts and insights about Ductal Carcinoma
Primary ICD-10-CM Codes for ductal carcinoma
Decision Criteria
clinical Criteria
- Histological confirmation of invasive ductal carcinoma
documentation Criteria
- Lack of specific site documentation within the breast
Applicable To
- Invasive ductal carcinoma of unspecified site of right breast
Excludes
- Benign neoplasm of breast
- Carcinoma in situ of breast
Clinical Validation Requirements
- Histological confirmation of invasive ductal carcinoma
- Imaging studies indicating malignancy
Code-Specific Risks
- Risk of under-coding if specific site is documented but not coded.
Coding Notes
- Ensure laterality and specific site are documented to avoid unspecified coding.
D05.10 - Carcinoma in situ of unspecified breast
Use when DCIS is confirmed without specification of laterality.
Applicable To
- Ductal carcinoma in situ (DCIS) of unspecified breast
Excludes
- Invasive ductal carcinoma
Clinical Validation Requirements
- Pathology report confirming DCIS
- Absence of invasive components
Coding Notes
Ensure documentation specifies in situ status to avoid confusion with invasive carcinoma.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Ductal Carcinoma to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code C50.911.
Impact
Clinical: Affects treatment decisions and prognosis., Regulatory: Non-compliance with documentation standards., Financial: Potential impact on reimbursement for targeted therapies.
Mitigation Strategy
Ensure receptor status is included in pathology reports., Review clinical notes for completeness before coding.
Impact
Reimbursement: May lead to reduced reimbursement due to lack of specificity., Compliance: Non-compliance with coding guidelines requiring specificity., Data Quality: Decreases accuracy of health records and data analytics.
Mitigation Strategy
Ensure documentation specifies the site and use the most specific code available.
Impact
Audits may target unspecified codes when documentation supports more specific coding.
Mitigation Strategy
Ensure all documentation is reviewed for specificity before coding.
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 Ductal Carcinoma, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Ductal Carcinoma
Use these documentation templates to ensure complete and accurate documentation for Ductal Carcinoma. These templates include all required elements for proper coding and billing.
Invasive ductal carcinoma diagnosis
Specialty: OncologyRequired Elements
- Histologic type
- Tumor size
- Grade
- Lymph node involvement
- Receptor status
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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