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v1.0.0
ICD-10 Guide
ICD-10 CodesChapter 2: NeoplasmsC66

C66

Billable

Malignant neoplasm of ureter

Chapter 2:Neoplasms

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

Code Description

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

Key Diagnostic Point:

Malignant neoplasm of the ureter refers to cancerous growths that originate in the ureter, the tube that carries urine from the kidneys to the bladder. This type of cancer is relatively rare and can be classified into various histological types, including transitional cell carcinoma, squamous cell carcinoma, and adenocarcinoma. Symptoms may include hematuria (blood in urine), flank pain, and urinary obstruction. Diagnosis typically involves imaging studies such as CT scans, MRIs, or ultrasounds, followed by cystoscopy and biopsy for definitive histological diagnosis. Staging of ureteral cancer is crucial for determining the extent of disease and guiding treatment options. The American Joint Committee on Cancer (AJCC) staging system is commonly used, categorizing the cancer based on tumor size, lymph node involvement, and presence of metastasis. Surgical management often involves nephroureterectomy, which is the removal of the affected ureter along with the kidney, and may include lymphadenectomy if lymph nodes are involved. Adjuvant therapies such as chemotherapy or radiation may be considered based on the stage and grade of the tumor.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Variety of histological types requiring specific documentation
  • Need for accurate staging information
  • Potential for metastasis complicating coding
  • Variability in surgical management approaches

Audit Risk Factors

  • Inadequate documentation of staging
  • Failure to specify the histological type of cancer
  • Missing surgical details in operative reports
  • Inaccurate coding of associated conditions

Specialty Focus

Medical Specialties

Urology

Documentation Requirements

Detailed operative reports, pathology reports, and imaging studies must be documented.

Common Clinical Scenarios

Diagnosis and management of ureteral tumors, post-operative follow-ups, and treatment planning.

Billing Considerations

Ensure accurate staging and histological type are documented to support coding.

Oncology

Documentation Requirements

Comprehensive treatment plans, chemotherapy regimens, and follow-up care notes.

Common Clinical Scenarios

Management of advanced ureteral cancer, coordination of care with urology, and palliative care considerations.

Billing Considerations

Documentation of tumor response to treatment and any complications arising from therapy.

Coding Guidelines

Inclusion Criteria

Use C66 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the neoplasm's location, histology, and staging
  • Include any relevant surgical procedures and associated conditions

Exclusion Criteria

Do NOT use C66 When
No specific exclusions found.

Related CPT Codes

50590CPT Code

Nephroureterectomy

Clinical Scenario

Performed for malignant neoplasm of the ureter.

Documentation Requirements

Operative report detailing the procedure and findings.

Specialty Considerations

Urology specialists must document the extent of resection and any complications.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of ureteral malignancies, improving data accuracy and facilitating better patient management through detailed documentation of tumor characteristics.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of ureteral malignancies, improving data accuracy and facilitating better patient management through detailed documentation of tumor characteristics.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of ureteral malignancies, improving data accuracy and facilitating better patient management through detailed documentation of tumor characteristics.

Resources

Clinical References

  • •
    American Cancer Society - Ureteral Cancer

Coding & Billing References

  • •
    American Cancer Society - Ureteral Cancer

Frequently Asked Questions

What are the common symptoms of malignant neoplasm of the ureter?

Common symptoms include hematuria, flank pain, and urinary obstruction. Patients may also experience changes in urinary habits.