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v1.0.0
ICD-10 Guide
ICD-10 CodesC66.9

C66.9

Billable

Malignant neoplasm of unspecified ureter

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

Code Description

ICD-10 C66.9 is a billable code used to indicate a diagnosis of malignant neoplasm of unspecified ureter.

Key Diagnostic Point:

C66.9 refers to a malignant neoplasm located in the ureter, which is the duct through which urine passes from the kidney to the bladder. This code is used when the specific site of the malignancy within the ureter is not specified. Ureteral malignancies are relatively rare and can arise from transitional cell carcinoma, squamous cell carcinoma, or adenocarcinoma. Symptoms may include hematuria (blood in urine), flank pain, and urinary obstruction. Diagnosis typically involves imaging studies such as CT scans or MRIs, and may be confirmed through biopsy. Staging of ureteral cancer follows the TNM system, assessing tumor size (T), lymph node involvement (N), and presence of metastasis (M). Treatment options may include surgical resection, chemotherapy, and radiation therapy, depending on the stage and location of the tumor. Accurate coding is essential for appropriate treatment planning and reimbursement.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in tumor location and staging
  • Need for precise documentation of malignancy type
  • Differentiation from benign conditions
  • Potential for multiple treatment modalities

Audit Risk Factors

  • Inadequate documentation of tumor characteristics
  • Failure to specify the site of malignancy
  • Incorrect staging of the cancer
  • Lack of supporting clinical evidence for treatment

Specialty Focus

Medical Specialties

Urology

Documentation Requirements

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

Common Clinical Scenarios

Diagnosis of ureteral cancer, management of urinary obstruction, and post-operative follow-up.

Billing Considerations

Ensure clear documentation of tumor location and staging to support coding.

Oncology

Documentation Requirements

Comprehensive treatment plans, chemotherapy regimens, and follow-up assessments.

Common Clinical Scenarios

Chemotherapy administration, radiation therapy planning, and palliative care.

Billing Considerations

Accurate staging and treatment documentation are crucial for coding and reimbursement.

Coding Guidelines

Inclusion Criteria

Use C66.9 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the code is used only when the specific site of the ureteral malignancy is not documented
  • Include relevant clinical information to support the diagnosis

Exclusion Criteria

Do NOT use C66.9 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

50590CPT Code

Ureteral stent placement

Clinical Scenario

Used in cases of ureteral obstruction due to malignancy.

Documentation Requirements

Document indication for stent placement and any imaging studies.

Specialty Considerations

Urology specialists should ensure clear documentation of the malignancy and its impact on urinary function.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of malignancies, improving the accuracy of cancer registries and treatment planning. C66.9 provides a necessary code for cases where the ureteral malignancy is not specified, ensuring that these patients receive appropriate care.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of malignancies, improving the accuracy of cancer registries and treatment planning. C66.9 provides a necessary code for cases where the ureteral malignancy is not specified, ensuring that these patients receive appropriate care.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of malignancies, improving the accuracy of cancer registries and treatment planning. C66.9 provides a necessary code for cases where the ureteral malignancy is not specified, ensuring that these patients receive appropriate care.

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 document to support the use of C66.9?

Document the patient's symptoms, imaging findings, biopsy results, and any treatment plans. Ensure that the malignancy is clearly indicated as unspecified to justify the use of C66.9.