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v1.0.0
ICD-10 Guide
ICD-10 CodesC53.1

C53.1

Billable

Malignant neoplasm of exocervix

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

Code Description

ICD-10 C53.1 is a billable code used to indicate a diagnosis of malignant neoplasm of exocervix.

Key Diagnostic Point:

C53.1 refers to malignant neoplasms located specifically in the exocervix, which is the outer part of the cervix that protrudes into the vagina. This type of cancer is often associated with human papillomavirus (HPV) infection, which is a significant risk factor. Symptoms may include abnormal vaginal bleeding, pelvic pain, and unusual discharge. Diagnosis typically involves a Pap smear followed by a biopsy to confirm malignancy. Staging of cervical cancer is crucial for determining treatment options and prognosis, with the FIGO staging system commonly used. Treatment may involve surgery, radiation, and chemotherapy, depending on the stage of the disease. The CA-125 blood test is not typically used for cervical cancer but may be relevant in cases of ovarian cancer or other gynecological malignancies. Surgical approaches can include conization, hysterectomy, and lymphadenectomy, depending on the extent of the disease. Accurate coding is essential for proper treatment planning and reimbursement.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between stages of cervical cancer
  • Understanding the relationship between HPV and cervical cancer
  • Navigating the various treatment options and their implications
  • Interpreting pathology reports for accurate coding

Audit Risk Factors

  • Inaccurate staging of the cancer
  • Misinterpretation of pathology reports
  • Failure to document HPV status
  • Inconsistent documentation of treatment plans

Specialty Focus

Medical Specialties

Gynecologic Oncology

Documentation Requirements

Detailed pathology reports, treatment plans, and staging information.

Common Clinical Scenarios

Diagnosis and treatment planning for cervical cancer, follow-up care post-surgery.

Billing Considerations

Ensure accurate documentation of HPV status and staging to support coding.

Radiation Oncology

Documentation Requirements

Radiation treatment plans, imaging studies, and response assessments.

Common Clinical Scenarios

Patients receiving radiation therapy for cervical cancer.

Billing Considerations

Document the specific radiation techniques used and any side effects experienced by the patient.

Coding Guidelines

Inclusion Criteria

Use C53.1 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the diagnosis, staging, and treatment
  • Include any relevant co
  • morbid conditions that may affect the patient's care

Exclusion Criteria

Do NOT use C53.1 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

58150CPT Code

Total abdominal hysterectomy

Clinical Scenario

Used for surgical treatment of C53.1 when the cancer is localized.

Documentation Requirements

Operative report detailing the procedure and findings.

Specialty Considerations

Ensure the surgical approach is documented clearly.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of cervical cancers, improving the accuracy of data collection and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of cervical cancers, improving the accuracy of data collection and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

Resources

Clinical References

  • •
    American Cancer Society - Cervical Cancer

Coding & Billing References

  • •
    American Cancer Society - Cervical Cancer

Frequently Asked Questions

What is the significance of HPV in C53.1?

HPV is a major risk factor for the development of cervical cancer, including malignant neoplasms of the exocervix. Accurate documentation of HPV status is crucial for treatment planning and coding.