ICD-10 Coding for Lumpectomy(C50.911)
Complete ICD-10-CM coding and documentation guide for Lumpectomy. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Lumpectomy
C50.0-C50.9Primary Range
Malignant neoplasm of breast
This range includes codes for breast cancer, which is the primary condition treated with lumpectomy.
Key Information: ICD-10 code for lumpectomy
Essential facts and insights about Lumpectomy
Primary ICD-10-CM Code for lumpectomy
Decision Criteria
clinical Criteria
- Presence of malignant breast tumor
Applicable To
- Breast cancer
Excludes
- Benign breast lesions
Clinical Validation Requirements
- Pathology report confirming malignancy
- Operative note specifying margin assessment
Code-Specific Risks
- Incorrect use for benign conditions
Coding Notes
- Ensure documentation specifies oncologic intent and margin assessment.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Sentinel node biopsy
38525Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Benign neoplasm of breast
D24.1Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Lumpectomy to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code C50.911.
Impact
Clinical: Inadequate treatment documentation, Regulatory: Non-compliance with surgical standards, Financial: Potential claim denials
Mitigation Strategy
Use standardized templates, Verify margin details before submission
Impact
Reimbursement: Incorrect billing leading to denials, Compliance: Non-compliance with coding guidelines, Data Quality: Inaccurate clinical data reporting
Mitigation Strategy
Use code 19120 for benign lesions without oncologic intent.
Impact
Failure to document margin status can trigger audits.
Mitigation Strategy
Implement mandatory margin documentation protocols.
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 Lumpectomy, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Lumpectomy
Use these documentation templates to ensure complete and accurate documentation for Lumpectomy. These templates include all required elements for proper coding and billing.
Oncologic lumpectomy with sentinel node biopsy
Specialty: Surgical OncologyRequired Elements
- Lesion localization method
- Margin inking and orientation
- Sentinel node identification
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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