ICD-10 Coding for Ovarian Mass(N83.201, C56.3)
Complete ICD-10-CM coding and documentation guide for Ovarian Mass. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Ovarian Mass
N83.20-N83.29Primary Range
Non-inflammatory disorders of ovary, fallopian tube and broad ligament
This range includes codes for ovarian cysts, which are common presentations of ovarian masses.
Benign neoplasm of ovary
This range covers benign ovarian neoplasms, which can present as ovarian masses.
Malignant neoplasm of ovary
This range includes codes for malignant ovarian tumors, which are critical to differentiate from benign masses.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| N83.201 | Unspecified ovarian cyst, right side | Use when imaging confirms a right-sided ovarian cyst without solid components. |
|
| C56.3 | Malignant neoplasm of ovary, bilateral | Use for confirmed bilateral ovarian cancer with supporting imaging and lab results. |
|
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 right ovarian cyst
Essential facts and insights about Ovarian Mass
Primary ICD-10-CM Codes for ovarian mass
Decision Criteria
clinical Criteria
- Cyst size and characteristics on ultrasound
Applicable To
- Right ovarian cyst
Excludes
- Benign neoplasm of ovary (D27.0)
Clinical Validation Requirements
- Imaging showing simple cyst <5cm
- No solid components on ultrasound
Code-Specific Risks
- Confusion with neoplasm codes
- Incorrect laterality documentation
Coding Notes
- Ensure laterality is documented in the medical record.
C56.3 - Malignant neoplasm of ovary, bilateral
Use for confirmed bilateral ovarian cancer with supporting imaging and lab results.
Applicable To
- Bilateral ovarian cancer
Excludes
- Benign neoplasm of ovary (D27.0)
Clinical Validation Requirements
- Imaging showing complex masses with ascites
- Elevated CA-125 >200
Coding Notes
Ensure documentation of bilaterality and malignancy.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Ovarian Mass to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code N83.201.
Impact
Clinical: May lead to inappropriate treatment decisions., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials or reduced reimbursement.
Mitigation Strategy
Ensure lab results are included in the patient's chart, Cross-reference lab and imaging findings
Impact
Reimbursement: May lead to claim denials or reduced reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate data for clinical and research purposes.
Mitigation Strategy
Always verify imaging reports and clinical notes for laterality.
Impact
Failure to document laterality can lead to incorrect coding.
Mitigation Strategy
Implement a checklist for imaging and clinical documentation.
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 Ovarian Mass, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Ovarian Mass
Use these documentation templates to ensure complete and accurate documentation for Ovarian Mass. These templates include all required elements for proper coding and billing.
Ovarian cyst with surgical intervention
Specialty: GynecologyRequired Elements
- Cyst size and laterality
- Imaging findings
- Surgical plan
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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