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ICD-10 Guide
ICD-10 CodesC56.9

C56.9

Billable

Malignant neoplasm of unspecified ovary

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

Code Description

ICD-10 C56.9 is a billable code used to indicate a diagnosis of malignant neoplasm of unspecified ovary.

Key Diagnostic Point:

C56.9 refers to a malignant neoplasm of the ovary where the specific site is not identified. Ovarian cancer is a significant gynecologic malignancy, often diagnosed at an advanced stage due to vague symptoms. The neoplasm can arise from various cell types, including epithelial, germ cell, and stromal cells. Symptoms may include abdominal bloating, pelvic pain, and changes in urinary habits. Diagnosis typically involves imaging studies, such as ultrasound or CT scans, and tumor markers like CA-125, which can aid in monitoring treatment response and disease progression. Staging of ovarian cancer is crucial for treatment planning and is based on the FIGO system, which considers tumor size, spread to lymph nodes, and distant metastasis. Treatment often involves a combination of surgery and chemotherapy, with surgical approaches including total abdominal hysterectomy and bilateral salpingo-oophorectomy, depending on the extent of the disease.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in staging and treatment protocols
  • Need for precise documentation of tumor characteristics
  • Differentiation from benign ovarian conditions
  • Potential for multiple sites of involvement

Audit Risk Factors

  • Inadequate documentation of tumor staging
  • Failure to document CA-125 levels and their significance
  • Misclassification of benign versus malignant conditions
  • Lack of clarity on surgical procedures performed

Specialty Focus

Medical Specialties

Oncology

Documentation Requirements

Detailed pathology reports, imaging studies, and treatment plans.

Common Clinical Scenarios

Diagnosis and treatment planning for ovarian cancer, monitoring treatment response.

Billing Considerations

Ensure accurate staging and documentation of tumor markers.

Gynecology

Documentation Requirements

Surgical notes, pre-operative assessments, and post-operative follow-ups.

Common Clinical Scenarios

Surgical intervention for ovarian masses, management of ovarian cancer.

Billing Considerations

Document the extent of disease and any findings during surgery.

Coding Guidelines

Inclusion Criteria

Use C56.9 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the diagnosis, staging, and treatment
  • Include any relevant imaging and laboratory results to support the coding

Exclusion Criteria

Do NOT use C56.9 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

58150CPT Code

Total abdominal hysterectomy

Clinical Scenario

Performed for malignant neoplasm of the ovary.

Documentation Requirements

Operative report detailing the procedure and findings.

Specialty Considerations

Oncology and gynecology must coordinate on staging and treatment.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of ovarian cancers, improving data accuracy and treatment tracking. C56.9 provides a necessary code for unspecified cases, ensuring that all malignancies are captured for epidemiological and treatment purposes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of ovarian cancers, improving data accuracy and treatment tracking. C56.9 provides a necessary code for unspecified cases, ensuring that all malignancies are captured for epidemiological and treatment purposes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of ovarian cancers, improving data accuracy and treatment tracking. C56.9 provides a necessary code for unspecified cases, ensuring that all malignancies are captured for epidemiological and treatment purposes.

Resources

Clinical References

  • •
    American Cancer Society - Ovarian Cancer

Coding & Billing References

  • •
    American Cancer Society - Ovarian Cancer

Frequently Asked Questions

What does C56.9 represent?

C56.9 represents a malignant neoplasm of the ovary where the specific site is not specified, requiring careful documentation to support the diagnosis.