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v1.0.0
ICD-10 Guide
ICD-10 CodesC56.1

C56.1

Billable

Malignant neoplasm of right ovary

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 C56.1 is a billable code used to indicate a diagnosis of malignant neoplasm of right ovary.

Key Diagnostic Point:

C56.1 refers to a malignant neoplasm specifically located in the right ovary. This condition is characterized by the uncontrolled growth of abnormal cells in the ovarian tissue, which can lead to the formation of tumors. Gynecologic malignancies, including ovarian cancer, are often diagnosed at advanced stages due to subtle symptoms that may be mistaken for benign conditions. The staging of ovarian cancer is crucial for determining treatment options and prognosis, typically classified using the FIGO (International Federation of Gynecology and Obstetrics) system, which ranges from Stage I (localized) to Stage IV (distant metastasis). CA-125 is a tumor marker frequently used in the diagnosis and monitoring of ovarian cancer, although it is not exclusively specific to this malignancy. Surgical approaches for managing malignant neoplasms of the ovary often involve procedures such as oophorectomy (removal of the ovary) or total abdominal hysterectomy with bilateral salpingo-oophorectomy (TAH-BSO), depending on the stage and extent of the disease. Accurate coding of C56.1 requires comprehensive documentation of the diagnosis, staging, and treatment plan.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Need for accurate staging information
  • Variability in symptoms and presentation
  • Use of tumor markers like CA-125
  • Potential for metastasis affecting coding

Audit Risk Factors

  • Inadequate documentation of staging
  • Failure to document CA-125 levels
  • Lack of clarity in surgical procedure descriptions
  • Misclassification of tumor type

Specialty Focus

Medical Specialties

Gynecologic Oncology

Documentation Requirements

Detailed pathology reports, imaging studies, and surgical notes are essential.

Common Clinical Scenarios

Diagnosis and treatment planning for newly diagnosed ovarian cancer, follow-up care for recurrence.

Billing Considerations

Ensure all staging information is documented, including any metastasis.

Radiology

Documentation Requirements

Imaging reports must clearly indicate findings related to the right ovary.

Common Clinical Scenarios

Preoperative imaging for staging and surgical planning.

Billing Considerations

Radiologists should provide detailed descriptions of any masses or abnormalities.

Coding Guidelines

Inclusion Criteria

Use C56.1 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the diagnosis, staging, and any associated procedures
  • Include any relevant clinical findings and treatment plans

Exclusion Criteria

Do NOT use C56.1 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

58150CPT Code

Total abdominal hysterectomy with bilateral salpingo-oophorectomy

Clinical Scenario

Used for surgical treatment of C56.1.

Documentation Requirements

Operative report detailing the procedure and findings.

Specialty Considerations

Gynecologic oncologists should ensure comprehensive documentation of the surgical approach.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of ovarian malignancies, improving data accuracy and enhancing treatment tracking.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of ovarian malignancies, improving data accuracy and enhancing treatment tracking.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of ovarian malignancies, improving data accuracy and enhancing treatment tracking.

Resources

Clinical References

  • •
    American Cancer Society - Ovarian Cancer

Coding & Billing References

  • •
    American Cancer Society - Ovarian Cancer

Frequently Asked Questions

What is the significance of CA-125 in coding C56.1?

CA-125 is a tumor marker that can aid in the diagnosis and monitoring of ovarian cancer. While it is not required for coding, its levels should be documented as they can provide important clinical context.