ICD-10 Coding for Metastatic Breast Cancer(C50.911, C78.7)
Complete ICD-10-CM coding and documentation guide for Metastatic Breast Cancer. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Metastatic Breast Cancer
C50.0-C50.9Primary Range
Malignant neoplasm of breast
Primary codes for breast cancer, specifying site and laterality.
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 | When breast cancer is confirmed but specific site is not documented. |
|
| C78.7 | Secondary malignant neoplasm of liver | When breast cancer has metastasized to the liver. |
|
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 metastatic breast cancer
Essential facts and insights about Metastatic Breast Cancer
Primary ICD-10-CM Codes for metastatic breast cancer
Decision Criteria
documentation Criteria
- Document laterality and specific site of breast cancer.
Applicable To
- Breast cancer, NOS
Excludes
- Benign neoplasm of breast (D24.-)
Clinical Validation Requirements
- Biopsy confirming malignancy
- Imaging showing mass in breast
Code-Specific Risks
- Use of unspecified code may lead to audits.
Coding Notes
- Ensure laterality is documented to avoid unspecified codes.
C78.7 - Secondary malignant neoplasm of liver
When breast cancer has metastasized to the liver.
Applicable To
- Liver metastasis
Excludes
- Primary liver cancer (C22.-)
Clinical Validation Requirements
- CT scan showing liver lesions
- Elevated liver function tests
Coding Notes
Sequence secondary code before primary if focus is on metastasis.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Estrogen receptor positive status
Z17.0Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Metastatic Breast Cancer 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 affect treatment decisions., Regulatory: Non-compliance with coding guidelines., Financial: Potential for reduced reimbursement.
Mitigation Strategy
Always include lab results for ER/PR status., Use templates to ensure completeness.
Impact
Reimbursement: May lead to reduced reimbursement., Compliance: Increases risk of audits., Data Quality: Decreases accuracy of clinical data.
Mitigation Strategy
Always document and code specific site and laterality.
Impact
Use of unspecified codes can trigger audits.
Mitigation Strategy
Ensure documentation supports specific 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 Metastatic Breast Cancer, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Metastatic Breast Cancer
Use these documentation templates to ensure complete and accurate documentation for Metastatic Breast Cancer. These templates include all required elements for proper coding and billing.
Metastatic breast cancer with bone metastasis
Specialty: OncologyRequired Elements
- Primary and secondary sites
- Hormone receptor status
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Metastatic Breast Cancer? Ask your questions below.