ICD-10 Logo
ICDxICD-10 Medical Coding
ICD-10 Logo
ICDxICD-10 Medical Coding
ICD 10 CodesDiagnoses
ICD 10 CodesDiagnoses
ICD-10 Logo
ICDxICD-10 Medical Coding

Comprehensive ICD-10-CM code reference with AI-powered search capabilities.

© 2025 ICD Code Compass. All rights reserved.

Browse

  • All Chapters
  • All Categories
  • Diagnoses

Tools

  • AI Code Search
ICD-10-CM codes are maintained by the CDC and CMS. This tool is for reference purposes only.
v1.0.0
ICD-10 Guide
ICD-10 CodesC67.6

C67.6

Billable

Malignant neoplasm of ureteric orifice

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

Code Description

ICD-10 C67.6 is a billable code used to indicate a diagnosis of malignant neoplasm of ureteric orifice.

Key Diagnostic Point:

C67.6 refers to a malignant neoplasm located at the ureteric orifice, which is the opening where the ureters connect to the bladder. This type of cancer is part of the broader category of urinary tract malignancies, which can include cancers of the bladder, ureters, and kidneys. The ureteric orifice is particularly significant as it can be affected by transitional cell carcinoma, the most common type of bladder cancer, which may extend into the ureter. Symptoms may include hematuria (blood in urine), urinary obstruction, and changes in urinary habits. Diagnosis typically involves imaging studies, cystoscopy, and biopsy. Staging of the cancer is crucial for determining the extent of disease and guiding treatment options, which may include surgical resection, chemotherapy, or radiation therapy. Surgical management often involves procedures such as ureterectomy or radical cystectomy, depending on the tumor's size and spread. Accurate coding for C67.6 is essential for proper treatment planning and reimbursement.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between malignant and benign conditions
  • Understanding the anatomical location and implications of the ureteric orifice
  • Staging requirements for accurate coding
  • Potential for overlapping codes with bladder and ureter cancers

Audit Risk Factors

  • Inadequate documentation of staging
  • Failure to specify the exact location of the neoplasm
  • Misclassification of the tumor type
  • Lack of supporting imaging or biopsy results

Specialty Focus

Medical Specialties

Urology

Documentation Requirements

Detailed operative reports, imaging studies, and pathology results are essential.

Common Clinical Scenarios

Diagnosis and management of transitional cell carcinoma, ureteral obstruction due to tumors.

Billing Considerations

Urologists must ensure accurate staging and documentation of tumor characteristics.

Oncology

Documentation Requirements

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

Common Clinical Scenarios

Management of advanced urinary tract malignancies and coordination of multidisciplinary care.

Billing Considerations

Oncologists should document the rationale for treatment choices and patient responses.

Coding Guidelines

Inclusion Criteria

Use C67.6 When
  • According to the ICD
  • CM guidelines, C67
  • 6 should be used when the documentation specifies a malignant neoplasm at the ureteric orifice
  • Coders must ensure that the diagnosis is confirmed through appropriate diagnostic procedures and that staging is documented

Exclusion Criteria

Do NOT use C67.6 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

50590CPT Code

Ureterectomy

Clinical Scenario

Performed for malignant tumors at the ureteric orifice.

Documentation Requirements

Operative report detailing the procedure and findings.

Specialty Considerations

Urologists 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 urinary tract malignancies, including C67.6, which enhances the accuracy of data collection and reimbursement processes. This specificity aids in better tracking of treatment outcomes and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of urinary tract malignancies, including C67.6, which enhances the accuracy of data collection and reimbursement processes. This specificity aids in better tracking of treatment outcomes and resource allocation.

Reimbursement & Billing Impact

reimbursement processes. This specificity aids in better tracking of treatment outcomes and resource allocation.

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 are the common symptoms of a malignant neoplasm of the ureteric orifice?

Common symptoms include hematuria, urinary obstruction, dysuria, and changes in urinary frequency. Patients may also experience flank pain or recurrent urinary tract infections.

How is a malignant neoplasm of the ureteric orifice diagnosed?

Diagnosis typically involves imaging studies such as CT scans or MRIs, followed by cystoscopy and biopsy to confirm the presence of malignancy.

What treatment options are available for C67.6?

Treatment options may include surgical resection (ureterectomy), chemotherapy, and radiation therapy, depending on the stage and extent of the cancer.

What documentation is required for coding C67.6?

Coders need detailed operative reports, imaging results, and pathology findings to accurately code C67.6 and support the diagnosis.