Malignant neoplasms of breast
ICD-10 Codes (0)
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Updates & Changes
FY 2026 Updates
New Codes (1)
Revised Codes (1)
Deleted Codes
No codes deleted in this range for FY 2026
Historical Changes
- •FY 2025: Routine maintenance updates with minor terminology clarifications
- •FY 2024: Enhanced specificity requirements for certain code ranges
- •FY 2023: Updated documentation guidelines for improved clarity
Upcoming Changes
- •Proposed updates pending review by Coordination and Maintenance Committee
- •Under consideration: Enhanced digital health integration codes
Implementation Guidance
- •Review all FY 2026 updates for C50-C50 codes before implementation
- •Always verify the most current codes in the ICD-10-CM manual
- •Ensure clinical documentation supports the selected diagnosis codes
- +3 more guidance items...
Range Overview
The ICD-10 code range C50-C50 pertains to malignant neoplasms of the breast. This includes cancers originating from different parts of the breast such as the nipple, areola, central portion, upper-inner quadrant, lower-inner quadrant, upper-outer quadrant, lower-outer quadrant, and axillary tail. The codes also differentiate between male and female patients, and between unilateral and bilateral conditions.
Key Usage Points:
- •C50 codes are used for both initial and subsequent encounters.
- •Specify laterality (left, right, bilateral) when coding.
- •Use additional codes to identify estrogen receptor status (Z17.0, Z17.1).
- •For neoplasms of uncertain behavior of the breast, use code D48.6.
- •For benign neoplasms of the breast, use codes D24.-.
Coding Guidelines
When to Use:
- ✓When a patient is diagnosed with breast cancer.
- ✓During follow-up visits for breast cancer treatment.
- ✓When documenting metastasis from breast cancer.
- ✓When coding for history of breast cancer.
When NOT to Use:
- ✗When the breast cancer is in remission.
- ✗When the patient has a benign or non-cancerous breast tumor.
- ✗When the patient has a history of breast cancer, but no current diagnosis.
- ✗When the patient has a family history of breast cancer, but no personal diagnosis.
Code Exclusions
Always verify exclusions against the patient's medical record and the latest ICD-10-CM official guidelines.
Documentation Requirements
Documentation for C50-C50 codes should be comprehensive, including the type of breast cancer, location, laterality, and any associated secondary or metastatic sites. Information on the estrogen receptor status is also important.
Clinical Information:
- •Type of breast cancer
- •Location of the cancer within the breast
- •Laterality (left, right, or bilateral)
- •Presence of metastasis
- •Estrogen receptor status
Supporting Evidence:
- •Pathology reports
- •Imaging studies
- •Surgical notes
- •Oncology consultation notes
Good Documentation Example:
Patient diagnosed with invasive ductal carcinoma in the upper-outer quadrant of the right breast. Pathology report confirms estrogen receptor positive status.
Poor Documentation Example:
Breast cancer diagnosed.
Common Documentation Errors:
- ⚠Not specifying the type of breast cancer
- ⚠Failing to document the location within the breast
- ⚠Not indicating laterality
- ⚠Not documenting metastasis or estrogen receptor status
Range Statistics
Coding Complexity
C50-C50 codes require a moderate level of coding knowledge and expertise. The coder must understand the different types of breast cancer, be able to identify the location within the breast, and accurately code for laterality, metastasis, and estrogen receptor status.
Key Factors:
- ▸Determining the specific type of breast cancer
- ▸Identifying the exact location within the breast
- ▸Documenting laterality
- ▸Coding for metastasis and estrogen receptor status
Specialty Focus
C50-C50 codes are primarily used by oncologists, surgeons, and radiologists. They are also relevant for general practitioners and internists managing patients with breast cancer.
Primary Specialties:
Clinical Scenarios:
- • A 45-year-old female newly diagnosed with invasive lobular carcinoma in the left breast.
- • A 55-year-old male with recurrent ductal carcinoma in the right breast.
- • A 60-year-old female undergoing chemotherapy for bilateral breast cancer.
- • A 50-year-old female with metastatic breast cancer to the bone.
- • A 65-year-old female with history of estrogen receptor positive breast cancer, now in remission.
Resources & References
There are several resources available for coding malignant neoplasms of the breast. These include the ICD-10-CM official guidelines, clinical reference books, and educational materials on cancer coding.
Official Guidelines:
- ICD-10-CM Official Guidelines for Coding and Reporting
- American Hospital Association Coding Clinic
- National Cancer Institute's Physician Data Query (PDQ) database
Clinical References:
- American Cancer Society's Breast Cancer Guide
- National Comprehensive Cancer Network (NCCN) Guidelines for Breast Cancer
Educational Materials:
- American Health Information Management Association (AHIMA) Cancer Coding Fact Sheet
- American Academy of Professional Coders (AAPC) ICD-10-CM Training
Frequently Asked Questions
How do I code for a patient with bilateral breast cancer?
Use the appropriate C50 code for the type of cancer and add the fifth character for bilateral (3).