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ICD-10 Guide
ICD-10 CodesC67.1

C67.1

Billable

Malignant neoplasm of dome of bladder

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

Code Description

ICD-10 C67.1 is a billable code used to indicate a diagnosis of malignant neoplasm of dome of bladder.

Key Diagnostic Point:

C67.1 refers to a malignant neoplasm located at the dome of the bladder, which is the uppermost part of the bladder. This type of cancer is classified under urinary tract malignancies and can present with various symptoms, including hematuria (blood in urine), dysuria (painful urination), and urinary frequency. The diagnosis is typically confirmed through imaging studies such as CT scans or MRIs, followed by cystoscopy and biopsy. Staging of bladder cancer is crucial for determining the extent of the disease and guiding treatment options. The American Joint Committee on Cancer (AJCC) staging system is commonly used, which includes stages from 0 (non-invasive) to IV (metastatic disease). Surgical management often involves transurethral resection of the bladder tumor (TURBT) for early-stage cancers, while more advanced cases may require partial or radical cystectomy. Adjuvant therapies, including chemotherapy and immunotherapy, may also be indicated based on the tumor's characteristics and staging.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in staging and treatment protocols
  • Need for precise documentation of tumor location and characteristics
  • Differentiation from non-malignant conditions
  • Potential for metastasis requiring additional coding

Audit Risk Factors

  • Inadequate documentation of tumor size and staging
  • Failure to document the specific location of the neoplasm
  • Misclassification of tumor type (malignant vs. benign)
  • Inconsistent coding of associated procedures

Specialty Focus

Medical Specialties

Urology

Documentation Requirements

Detailed pathology reports, imaging studies, and surgical notes are essential.

Common Clinical Scenarios

Diagnosis and management of bladder tumors, staging evaluations, and surgical interventions.

Billing Considerations

Ensure accurate coding of tumor size, grade, and stage to reflect treatment decisions.

Oncology

Documentation Requirements

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

Common Clinical Scenarios

Management of advanced bladder cancer, including chemotherapy and immunotherapy.

Billing Considerations

Documenting response to treatment and any complications that arise during therapy.

Coding Guidelines

Inclusion Criteria

Use C67.1 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the neoplasm's location, size, and staging
  • Include any relevant treatment details and follow
  • up care

Exclusion Criteria

Do NOT use C67.1 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

52224CPT Code

Cystourethroscopy with biopsy

Clinical Scenario

Used for diagnosis and staging of bladder tumors.

Documentation Requirements

Document findings from cystoscopy and biopsy results.

Specialty Considerations

Urologists must ensure accurate reporting of tumor characteristics.

51570CPT Code

Partial cystectomy

Clinical Scenario

Performed for localized malignant tumors.

Documentation Requirements

Document the extent of resection and pathology findings.

Specialty Considerations

Urologists must provide detailed operative notes.

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, improving the accuracy of data collection and reimbursement processes. C67.1 provides a clear distinction for malignant neoplasms at the dome of the bladder, which aids in treatment planning and research.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of bladder cancers, improving the accuracy of data collection and reimbursement processes. C67.1 provides a clear distinction for malignant neoplasms at the dome of the bladder, which aids in treatment planning and research.

Reimbursement & Billing Impact

reimbursement processes. C67.1 provides a clear distinction for malignant neoplasms at the dome of the bladder, which aids in treatment planning and research.

Resources

Clinical References

  • •
    American Urological Association Guidelines
  • •
    National Comprehensive Cancer Network (NCCN) Guidelines

Coding & Billing References

  • •
    American Urological Association Guidelines
  • •
    National Comprehensive Cancer Network (NCCN) Guidelines

Frequently Asked Questions

What are the common symptoms of a malignant neoplasm of the dome of the bladder?

Common symptoms include hematuria, dysuria, urinary frequency, and pelvic pain. Patients may also experience weight loss and fatigue as the disease progresses.

How is staging determined for bladder cancer?

Staging is determined through imaging studies, cystoscopy, and biopsy results, following the AJCC staging system which assesses tumor size, lymph node involvement, and metastasis.