ICD-10 Coding for Metastatic Ovarian Cancer(C56.1, C56.2, C56.3, C78.6)
Complete ICD-10-CM coding and documentation guide for Metastatic Ovarian Cancer. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Metastatic Ovarian Cancer
C56-C57Primary Range
Malignant neoplasm of ovary and other uterine adnexa
This range includes primary ovarian cancers, which are essential for coding metastatic ovarian cancer.
Secondary malignant neoplasm of respiratory and digestive organs
This range includes codes for secondary sites of metastasis, crucial for documenting metastatic spread.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| C56.1 | Malignant neoplasm of right ovary | Use when the primary site of cancer is confirmed to be the right ovary. |
|
| C56.2 | Malignant neoplasm of left ovary | Use when the primary site of cancer is confirmed to be the left ovary. |
|
| C56.3 | Malignant neoplasm of bilateral ovaries | Use when the primary site of cancer is confirmed to be both ovaries. |
|
| C78.6 | Secondary malignant neoplasm of retroperitoneum and peritoneum | Use when there is confirmed metastatic spread to the peritoneum. |
|
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 ovarian cancer
Essential facts and insights about Metastatic Ovarian Cancer
Primary ICD-10-CM Codes for metastatic ovarian cancer
Decision Criteria
clinical Criteria
- Confirmed malignancy in the right ovary
Applicable To
- Primary malignant neoplasm of right ovary
Excludes
- Benign neoplasm of ovary (D27.-)
Clinical Validation Requirements
- Histological confirmation of malignancy
- Imaging studies showing ovarian mass
Code-Specific Risks
- Incorrect laterality documentation
Coding Notes
- Ensure laterality is documented to avoid unspecified coding.
C56.2 - Malignant neoplasm of left ovary
Use when the primary site of cancer is confirmed to be the left ovary.
Applicable To
- Primary malignant neoplasm of left ovary
Excludes
- Benign neoplasm of ovary (D27.-)
Clinical Validation Requirements
- Histological confirmation of malignancy
- Imaging studies showing ovarian mass
Coding Notes
Ensure laterality is documented to avoid unspecified coding.
C56.3 - Malignant neoplasm of bilateral ovaries
Use when the primary site of cancer is confirmed to be both ovaries.
Applicable To
- Primary malignant neoplasm of both ovaries
Excludes
- Benign neoplasm of ovary (D27.-)
Clinical Validation Requirements
- Histological confirmation of malignancy
- Imaging studies showing bilateral ovarian masses
Coding Notes
Ensure bilateral involvement is documented to avoid unspecified coding.
C78.6 - Secondary malignant neoplasm of retroperitoneum and peritoneum
Use when there is confirmed metastatic spread to the peritoneum.
Applicable To
- Metastatic cancer to peritoneum
Excludes
- Primary peritoneal cancer (C48.-)
Clinical Validation Requirements
- Imaging studies showing peritoneal involvement
- Pathology reports confirming metastatic spread
Coding Notes
Ensure documentation specifies metastatic spread.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Encounter for antineoplastic chemotherapy
Z51.11Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Metastatic Ovarian Cancer to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code C56.1.
Impact
Clinical: Inaccurate treatment planning., Regulatory: Non-compliance with documentation standards., Financial: Potential for claim denials.
Mitigation Strategy
Ensure all metastatic sites are documented in clinical notes.
Impact
Reimbursement: May lead to claim denials or reduced reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Decreases accuracy of health records.
Mitigation Strategy
Document and code the specific laterality (right, left, bilateral).
Impact
High risk of audits when unspecified codes are used despite available specificity.
Mitigation Strategy
Ensure documentation supports the most specific code available.
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 Ovarian Cancer, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Metastatic Ovarian Cancer
Use these documentation templates to ensure complete and accurate documentation for Metastatic Ovarian Cancer. These templates include all required elements for proper coding and billing.
Metastatic Ovarian Cancer with Peritoneal Spread
Specialty: OncologyRequired Elements
- Primary site and laterality
- Metastatic sites
- Current treatment plan
- Complications
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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