ICD-10 Coding for Infiltrating Ductal Carcinoma of the Right Breast(C50.911, C50.211)
Complete ICD-10-CM coding and documentation guide for Infiltrating Ductal Carcinoma of the Right Breast. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Infiltrating Ductal Carcinoma of the Right Breast
C50.0-C50.9Primary Range
Malignant neoplasm of breast
This range includes all malignant neoplasms of the breast, with specific codes for laterality and quadrant.
Personal history of malignant neoplasm of breast
Used for patients with a history of breast cancer, important for follow-up and surveillance coding.
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 quadrant of the tumor is not documented. |
|
| C50.211 | Malignant neoplasm of upper-inner quadrant of right female breast | Use when the tumor is located in the upper-inner quadrant 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 infiltrating ductal carcinoma right breast
Essential facts and insights about Infiltrating Ductal Carcinoma of the Right Breast
Primary ICD-10-CM Codes for infiltrating ductal carcinoma right breast
Decision Criteria
clinical Criteria
- Confirmed invasive ductal carcinoma via biopsy
documentation Criteria
- Laterality must be specified as 'right'
Applicable To
- Breast cancer NOS right
Excludes
- In situ carcinoma of breast (D05._)
Clinical Validation Requirements
- Pathology report confirming invasive ductal carcinoma
- Imaging studies showing tumor in right breast
Code-Specific Risks
- Risk of undercoding if specific quadrant is known but not documented.
Coding Notes
- Ensure laterality is confirmed in documentation.
C50.211 - Malignant neoplasm of upper-inner quadrant of right female breast
Use when the tumor is located in the upper-inner quadrant of the right breast.
Applicable To
- Cancer of upper-inner quadrant right breast
Excludes
- In situ carcinoma of breast (D05._)
Clinical Validation Requirements
- Pathology report confirming invasive ductal carcinoma
- Imaging studies showing tumor in upper-inner quadrant
Coding Notes
Document specific quadrant and laterality.
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 Infiltrating Ductal Carcinoma of the Right Breast to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code C50.911.
Impact
Clinical: Impacts treatment decisions, particularly hormone therapy., Regulatory: Non-compliance with documentation standards., Financial: May affect reimbursement for targeted therapies.
Mitigation Strategy
Ensure receptor status is included in all pathology reports, Verify documentation completeness before coding
Impact
Reimbursement: May result in lower reimbursement rates., Compliance: Non-compliance with coding guidelines., Data Quality: Decreases accuracy of clinical data.
Mitigation Strategy
Always use the most specific code available based on documentation.
Impact
High risk of audit if unspecified codes are used when specific information is available.
Mitigation Strategy
Train staff to document and code with specificity.
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 Infiltrating Ductal Carcinoma of the Right Breast, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Infiltrating Ductal Carcinoma of the Right Breast
Use these documentation templates to ensure complete and accurate documentation for Infiltrating Ductal Carcinoma of the Right Breast. These templates include all required elements for proper coding and billing.
Documenting a confirmed case of IDC in the right breast
Specialty: OncologyRequired Elements
- Tumor size
- Histologic grade
- Receptor status
- Exact quadrant
- Laterality
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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