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v1.0.0
ICD-10 Guide
ICD-10 CodesC67.9

C67.9

Billable

Malignant neoplasm of bladder, unspecified

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

Code Description

ICD-10 C67.9 is a billable code used to indicate a diagnosis of malignant neoplasm of bladder, unspecified.

Key Diagnostic Point:

C67.9 refers to a malignant neoplasm of the bladder that is unspecified, meaning that the specific type of bladder cancer has not been identified. Bladder cancer is a significant health concern, often presenting with symptoms such as hematuria (blood in urine), dysuria (painful urination), and increased urinary frequency. The bladder is a hollow organ that stores urine, and malignant tumors can arise from the transitional epithelium lining the bladder. The staging of bladder cancer is crucial for determining treatment options and prognosis, typically classified using the TNM system (Tumor, Node, Metastasis). Treatment may involve surgical interventions such as transurethral resection of the bladder tumor (TURBT), radical cystectomy, or bladder-preserving therapies. The unspecified nature of this code can complicate treatment planning and coding accuracy, as it does not provide specific details about the tumor's characteristics or stage, which are essential for effective management and reimbursement.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Lack of specificity regarding tumor type and stage
  • Variability in treatment protocols based on tumor characteristics
  • Potential for misclassification with other urinary tract malignancies
  • Need for comprehensive documentation to support the diagnosis

Audit Risk Factors

  • Insufficient documentation of tumor characteristics
  • Inconsistent staging information
  • Failure to document treatment plans and outcomes
  • Misalignment between diagnosis and procedure codes

Specialty Focus

Medical Specialties

Urology

Documentation Requirements

Detailed pathology reports, imaging studies, and treatment plans must be documented.

Common Clinical Scenarios

Diagnosis of bladder cancer, management of recurrent tumors, and post-operative follow-up.

Billing Considerations

Ensure accurate staging and characterization of the tumor to avoid unspecified coding.

Oncology

Documentation Requirements

Comprehensive treatment history, including chemotherapy and radiation therapy details.

Common Clinical Scenarios

Management of advanced bladder cancer and coordination of multi-disciplinary care.

Billing Considerations

Document the rationale for treatment choices and any clinical trials involved.

Coding Guidelines

Inclusion Criteria

Use C67.9 When
  • According to the ICD
  • CM coding guidelines, C67
  • 9 should be used when the specific type of bladder cancer is not documented
  • Coders should ensure that all relevant clinical information is captured to support the diagnosis and treatment

Exclusion Criteria

Do NOT use C67.9 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

52260CPT Code

Cystourethroscopy, with biopsy

Clinical Scenario

Used when a patient presents with hematuria and requires biopsy to confirm bladder cancer diagnosis.

Documentation Requirements

Document indications for the procedure, findings, and any biopsies taken.

Specialty Considerations

Urologists must ensure accurate coding based on findings during the procedure.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more detailed coding of bladder cancer, but the unspecified nature of C67.9 can lead to challenges in treatment planning and reimbursement. Coders must ensure that they capture all relevant clinical information to avoid potential denials.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more detailed coding of bladder cancer, but the unspecified nature of C67.9 can lead to challenges in treatment planning and reimbursement. Coders must ensure that they capture all relevant clinical information to avoid potential denials.

Reimbursement & Billing Impact

reimbursement. Coders must ensure that they capture all relevant clinical information to avoid potential denials.

Resources

Clinical References

  • •
    American Urological Association Guidelines

Coding & Billing References

  • •
    American Urological Association Guidelines

Frequently Asked Questions

When should I use C67.9 instead of a more specific code?

C67.9 should be used when the specific type of bladder cancer is not documented in the medical record. If the pathology report or clinical notes specify the tumor type, a more specific code should be used.