ICD-10 Coding for Metastatic Renal Cell Carcinoma(C64.1, C64.2, C78.00, C79.51)
Complete ICD-10-CM coding and documentation guide for Metastatic Renal Cell Carcinoma. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Metastatic Renal Cell Carcinoma
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| C64.1 | Malignant neoplasm of right kidney, except renal pelvis | Use when RCC is confirmed in the right kidney. |
|
| C64.2 | Malignant neoplasm of left kidney, except renal pelvis | Use when RCC is confirmed in the left kidney. |
|
| C78.00 | Secondary malignant neoplasm of unspecified lung | Use for confirmed lung metastasis from RCC. |
|
| C79.51 | Secondary malignant neoplasm of bone | Use for confirmed bone metastasis from RCC. |
|
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 renal cell carcinoma
Essential facts and insights about Metastatic Renal Cell Carcinoma
Primary ICD-10-CM Codes for metastatic renal cell carcinoma
Decision Criteria
clinical Criteria
- Confirmed RCC in right kidney via imaging and biopsy
Applicable To
- Primary renal cell carcinoma of the right kidney
Excludes
- Renal pelvis carcinoma (C65.x)
Clinical Validation Requirements
- CT/MRI showing renal mass
- Biopsy confirming RCC
Code-Specific Risks
- Misclassification if laterality is not documented
Coding Notes
- Ensure laterality is documented to avoid unspecified coding.
C64.2 - Malignant neoplasm of left kidney, except renal pelvis
Use when RCC is confirmed in the left kidney.
Applicable To
- Primary renal cell carcinoma of the left kidney
Excludes
- Renal pelvis carcinoma (C65.x)
Clinical Validation Requirements
- CT/MRI showing renal mass
- Biopsy confirming RCC
Coding Notes
Ensure laterality is documented to avoid unspecified coding.
C78.00 - Secondary malignant neoplasm of unspecified lung
Use for confirmed lung metastasis from RCC.
Applicable To
- Metastatic RCC to lung
Excludes
- Primary lung cancer (C34.x)
Clinical Validation Requirements
- CT chest showing nodules
- Cytology consistent with RCC
Coding Notes
Link to primary RCC code.
C79.51 - Secondary malignant neoplasm of bone
Use for confirmed bone metastasis from RCC.
Applicable To
- Metastatic RCC to bone
Excludes
- Primary bone cancer (C41.x)
Clinical Validation Requirements
- Bone scan with SUV >2.5
- CT correlation for lytic lesions
Coding Notes
Link to primary RCC code.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Personal history of malignant neoplasm of kidney
Z85.5Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Malignant neoplasm of right renal pelvis
C65.1Malignant neoplasm of left renal pelvis
C65.2Malignant neoplasm of unspecified part of unspecified bronchus or lung
C34.90Malignant neoplasm of bone and articular cartilage, unspecified
C41.9Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Metastatic Renal Cell Carcinoma to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code C64.1.
Impact
Clinical: Inaccurate treatment planning., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials.
Mitigation Strategy
Always document laterality in clinical notes., Verify imaging reports for laterality.
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Always link secondary sites to primary RCC code.
Impact
Reimbursement: Claims may be denied for using history code., Compliance: Non-compliance with active treatment coding., Data Quality: Misrepresentation of patient's current condition.
Mitigation Strategy
Use C64.x for active disease, not history codes.
Impact
Failure to document all metastatic sites can lead to audit issues.
Mitigation Strategy
Implement checklist for documenting all metastatic sites.
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 Renal Cell Carcinoma, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Metastatic Renal Cell Carcinoma
Use these documentation templates to ensure complete and accurate documentation for Metastatic Renal Cell Carcinoma. These templates include all required elements for proper coding and billing.
Metastatic RCC with multiple sites
Specialty: OncologyRequired Elements
- Primary site documentation
- Metastatic sites
- Histology subtype
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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