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ICD-10 Guide
ICD-10 CodesC79.11

C79.11

Billable

Secondary malignant neoplasm of bladder

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

Code Description

ICD-10 C79.11 is a billable code used to indicate a diagnosis of secondary malignant neoplasm of bladder.

Key Diagnostic Point:

C79.11 refers to secondary malignant neoplasms of the bladder, indicating that the cancer has metastasized to the bladder from another primary site. This condition is often seen in patients with a history of malignancies such as breast, lung, or prostate cancer. The bladder serves as a site for metastatic disease due to its vascular supply and anatomical proximity to other organs. Patients may present with hematuria, urinary obstruction, or other urinary symptoms. Diagnosis typically involves imaging studies, such as CT scans or MRIs, and cystoscopy with biopsy to confirm the presence of malignant cells. Staging of the disease is crucial, as it influences treatment options and prognosis. The management of secondary malignant neoplasms often focuses on palliative care, especially when the primary tumor is advanced or when the metastatic disease is extensive. Treatment may include chemotherapy, radiation therapy, or supportive care to alleviate symptoms and improve quality of life.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Determining the primary site of cancer can be challenging.
  • Need for accurate staging to guide treatment decisions.
  • Differentiating between primary and secondary bladder tumors.
  • Documentation of metastatic disease requires comprehensive clinical details.

Audit Risk Factors

  • Inadequate documentation of the primary cancer site.
  • Failure to document staging of the metastatic disease.
  • Misclassification of primary vs. secondary tumors.
  • Lack of clarity in treatment intent (curative vs. palliative).

Specialty Focus

Medical Specialties

Oncology

Documentation Requirements

Detailed history of primary malignancy, staging information, and treatment plans.

Common Clinical Scenarios

Patients with known primary cancers presenting with urinary symptoms.

Billing Considerations

Ensure clear documentation of the metastatic process and treatment intent.

Urology

Documentation Requirements

Cystoscopy findings, biopsy results, and imaging studies.

Common Clinical Scenarios

Patients with hematuria and a history of cancer.

Billing Considerations

Document the extent of bladder involvement and any surgical interventions.

Coding Guidelines

Inclusion Criteria

Use C79.11 When
  • According to ICD
  • 10 coding guidelines, C79
  • 11 should be used when there is clear documentation of a secondary malignant neoplasm of the bladder
  • It is essential to confirm the primary site of cancer and document any relevant staging information

Exclusion Criteria

Do NOT use C79.11 When
  • Exclusion criteria include cases where the bladder tumor is primary rather than metastatic

Related ICD-10 Codes

Related CPT Codes

52000CPT Code

Cystoscopy

Clinical Scenario

Used for diagnosis and evaluation of bladder lesions.

Documentation Requirements

Cystoscopy findings and any biopsy results.

Specialty Considerations

Urologists must document the extent of the procedure and findings.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of secondary malignancies, improving the accuracy of cancer registries and treatment planning. C79.11 provides a clear distinction between primary and secondary tumors, which is crucial for patient management and research.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of secondary malignancies, improving the accuracy of cancer registries and treatment planning. C79.11 provides a clear distinction between primary and secondary tumors, which is crucial for patient management and research.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of secondary malignancies, improving the accuracy of cancer registries and treatment planning. C79.11 provides a clear distinction between primary and secondary tumors, which is crucial for patient management and research.

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 is the significance of coding C79.11 accurately?

Accurate coding of C79.11 is crucial for proper treatment planning, reimbursement, and cancer registry reporting. It ensures that patients receive appropriate care based on their metastatic disease status.