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v1.0.0
ICD-10 Guide
ICD-10 CodesC57.9

C57.9

Billable

Malignant neoplasm of female genital organ, unspecified

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

Code Description

ICD-10 C57.9 is a billable code used to indicate a diagnosis of malignant neoplasm of female genital organ, unspecified.

Key Diagnostic Point:

C57.9 refers to malignant neoplasms of female genital organs that are not specified in detail. This category encompasses a variety of gynecologic malignancies, including cancers of the uterus, cervix, ovaries, vulva, and vagina. The unspecified nature of this code indicates that the specific site of the malignancy has not been documented, which can complicate treatment planning and prognosis. Staging of gynecologic cancers is critical for determining the extent of disease and guiding therapy; however, without specific site information, accurate staging may be challenging. Tumor markers such as CA-125 are often utilized in the diagnosis and monitoring of ovarian cancer, but their relevance may vary depending on the specific type of malignancy. Surgical approaches can include hysterectomy, oophorectomy, or more extensive procedures depending on the tumor's location and stage. Accurate coding is essential for appropriate treatment and reimbursement, making it crucial for coders to understand the nuances of gynecologic malignancies.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Unspecified nature of the code can lead to ambiguity in documentation.
  • Variety of potential malignancies under this code complicates coding.
  • Staging information may be incomplete or lacking.
  • Need for correlation with tumor markers like CA-125 for accurate diagnosis.

Audit Risk Factors

  • Lack of specificity in documentation may lead to denials.
  • Inconsistent staging information can trigger audits.
  • Failure to document tumor markers may raise flags.
  • Surgical procedures not aligning with diagnosis can lead to audits.

Specialty Focus

Medical Specialties

Gynecologic Oncology

Documentation Requirements

Detailed pathology reports, staging information, and surgical notes are essential.

Common Clinical Scenarios

Diagnosis and treatment planning for various gynecologic cancers.

Billing Considerations

Ensure all relevant tumor markers and staging details are documented.

Radiology

Documentation Requirements

Imaging reports that detail findings related to gynecologic malignancies.

Common Clinical Scenarios

Imaging for staging and monitoring response to treatment.

Billing Considerations

Clear documentation of findings and correlation with clinical data is crucial.

Coding Guidelines

Inclusion Criteria

Use C57.9 When
  • According to ICD
  • 10 guidelines, C57
  • 9 should be used when the specific site of the malignant neoplasm is not documented
  • Coders should ensure that all relevant clinical information is available to support the use of this code

Exclusion Criteria

Do NOT use C57.9 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

58150CPT Code

Total abdominal hysterectomy

Clinical Scenario

Used when a hysterectomy is performed for suspected malignancy.

Documentation Requirements

Operative report detailing the procedure and findings.

Specialty Considerations

Gynecologic oncologists should ensure clear documentation of indications for surgery.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding, but C57.9 remains a challenge due to its unspecified nature. Coders must be diligent in ensuring that documentation supports the use of this code to avoid denials and ensure appropriate reimbursement.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding, but C57.9 remains a challenge due to its unspecified nature. Coders must be diligent in ensuring that documentation supports the use of this code to avoid denials and ensure appropriate reimbursement.

Reimbursement & Billing Impact

reimbursement.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What should I do if the specific site of the malignancy is not documented?

If the specific site is not documented, C57.9 can be used, but ensure that all other clinical information is thoroughly documented to support the diagnosis.