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ICD-10 Guide
ICD-10 CodesC67.2

C67.2

Billable

Malignant neoplasm of lateral wall of bladder

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

Code Description

ICD-10 C67.2 is a billable code used to indicate a diagnosis of malignant neoplasm of lateral wall of bladder.

Key Diagnostic Point:

C67.2 refers to a malignant neoplasm located specifically in the lateral wall of the bladder. This type of cancer arises from the transitional epithelium that lines the bladder and is characterized by uncontrolled cell growth. The lateral wall of the bladder is a common site for bladder tumors, which can present with symptoms such as hematuria (blood in urine), dysuria (painful urination), and increased urinary frequency. Diagnosis typically involves imaging studies such as ultrasound or CT scans, followed by cystoscopy for direct visualization and biopsy. Staging of bladder cancer is crucial for determining the extent of the disease and guiding treatment options. The most commonly used staging system is the TNM classification, which assesses tumor size (T), lymph node involvement (N), and distant metastasis (M). Surgical management may include transurethral resection of the bladder tumor (TURBT) for superficial tumors, or radical cystectomy for muscle-invasive disease. Adjuvant therapies, such as chemotherapy or immunotherapy, may also be indicated based on the stage and grade of the tumor.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Need for precise documentation of tumor location and staging
  • Differentiation between invasive and non-invasive tumors
  • Potential for multiple treatment modalities impacting coding
  • Variability in clinical presentation and symptoms

Audit Risk Factors

  • Inadequate documentation of tumor staging
  • Failure to specify the exact location of the neoplasm
  • Incorrect coding of associated procedures
  • Lack of clarity in treatment plans

Specialty Focus

Medical Specialties

Urology

Documentation Requirements

Complete surgical notes, pathology reports, imaging studies, and treatment plans.

Common Clinical Scenarios

Diagnosis and management of bladder tumors, staging evaluations, and post-operative follow-ups.

Billing Considerations

Ensure accurate documentation of tumor size, grade, and staging to support coding.

Oncology

Documentation Requirements

Detailed treatment plans, chemotherapy administration records, and follow-up assessments.

Common Clinical Scenarios

Management of advanced bladder cancer, chemotherapy regimens, and palliative care.

Billing Considerations

Document all treatment modalities and responses to therapy for accurate coding.

Coding Guidelines

Inclusion Criteria

Use C67.2 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the tumor's location, size, and staging
  • Include any relevant procedures performed, and ensure that the diagnosis aligns with the treatment provided

Exclusion Criteria

Do NOT use C67.2 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

52260CPT Code

Cystourethroscopy with biopsy

Clinical Scenario

Used for diagnosis of bladder tumors.

Documentation Requirements

Document indications for the procedure and findings.

Specialty Considerations

Urologists must ensure accurate reporting of biopsy results.

51570CPT Code

Radical cystectomy

Clinical Scenario

Performed for muscle-invasive bladder cancer.

Documentation Requirements

Complete operative report detailing the procedure.

Specialty Considerations

Oncologists should document any adjuvant therapies planned.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of bladder cancers, including the lateral wall neoplasm, which enhances data accuracy and improves patient care tracking.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of bladder cancers, including the lateral wall neoplasm, which enhances data accuracy and improves patient care tracking.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of bladder cancers, including the lateral wall neoplasm, which enhances data accuracy and improves patient care tracking.

Resources

Clinical References

  • •
    American Urological Association Guidelines
  • •
    National Comprehensive Cancer Network Guidelines

Coding & Billing References

  • •
    American Urological Association Guidelines
  • •
    National Comprehensive Cancer Network Guidelines

Frequently Asked Questions

What is the significance of staging in bladder cancer?

Staging is crucial as it determines the extent of the disease, guides treatment decisions, and helps predict patient outcomes.

How do I differentiate between malignant and benign bladder tumors?

Histological examination of biopsy samples is essential for differentiation, as benign tumors do not exhibit the same invasive characteristics as malignant ones.