ICD-10 Coding for Invasive Ductal Carcinoma(C50.911, C50.312)
Complete ICD-10-CM coding and documentation guide for Invasive Ductal Carcinoma. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Invasive Ductal Carcinoma
C50.0-C50.9Primary Range
Malignant neoplasm of breast
This range includes all codes for malignant neoplasms of the breast, including invasive ductal carcinoma.
Secondary malignant neoplasm of bone
Used for coding metastasis from primary breast cancer to bone.
Personal history of malignant neoplasm of breast
Used when documenting a history of breast cancer without active disease.
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 right breast is not documented. |
|
| C50.312 | Malignant neoplasm of upper-outer quadrant of left female breast | Use when the tumor is located in the upper outer quadrant of the left 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 invasive ductal carcinoma
Essential facts and insights about Invasive Ductal Carcinoma
Primary ICD-10-CM Codes for invasive ductal carcinoma
Decision Criteria
clinical Criteria
- Confirmed invasive ductal carcinoma on biopsy
documentation Criteria
- Laterality and quadrant not specified
Applicable To
- Invasive ductal carcinoma of right breast
Excludes
- In situ neoplasms (D05.-)
Clinical Validation Requirements
- Biopsy confirming invasive ductal carcinoma
- Imaging showing tumor size and location
Code-Specific Risks
- Risk of unspecified site leading to audit
Coding Notes
- Ensure laterality is documented to avoid unspecified coding.
C50.312 - Malignant neoplasm of upper-outer quadrant of left female breast
Use when the tumor is located in the upper outer quadrant of the left breast.
Applicable To
- Invasive ductal carcinoma of left upper outer quadrant
Excludes
- In situ neoplasms (D05.-)
Clinical Validation Requirements
- Biopsy confirming invasive ductal carcinoma
- Imaging showing tumor in upper outer quadrant
Coding Notes
Document specific quadrant to ensure accurate coding.
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 Invasive 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: May lead to incorrect treatment planning., Regulatory: Non-compliance with coding standards., Financial: Potential for denied claims due to unspecified coding.
Mitigation Strategy
Always document the side of the breast affected.
Impact
Reimbursement: Incorrect DRG assignment may affect payment., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate cancer registry data.
Mitigation Strategy
Always code the invasive component when both are present.
Impact
Using unspecified site codes without proper documentation.
Mitigation Strategy
Ensure documentation includes specific site and laterality.
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 Invasive Ductal Carcinoma, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Invasive Ductal Carcinoma
Use these documentation templates to ensure complete and accurate documentation for Invasive Ductal Carcinoma. These templates include all required elements for proper coding and billing.
Pathology report for IDC
Specialty: OncologyRequired Elements
- Tumor size
- Histologic grade
- Receptor status
- Lymph node involvement
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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