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v1.0.0
ICD-10 Guide
ICD-10 CodesC79.1

C79.1

Billable

Secondary malignant neoplasm of bladder and other and unspecified urinary organs

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

Code Description

ICD-10 C79.1 is a billable code used to indicate a diagnosis of secondary malignant neoplasm of bladder and other and unspecified urinary organs.

Key Diagnostic Point:

C79.1 refers to secondary malignant neoplasms that have metastasized to the bladder and other unspecified urinary organs. This condition typically arises from primary cancers located elsewhere in the body, such as the prostate, breast, or colon, which spread to the urinary system. The clinical presentation may include hematuria, urinary obstruction, or other urinary symptoms, depending on the extent of the metastasis. Diagnosis often involves imaging studies, such as CT scans or MRIs, and may require biopsy for definitive identification of the metastatic cells. Staging of the disease is crucial for determining prognosis and treatment options, which may include systemic therapies, radiation, or palliative care approaches aimed at managing symptoms and improving quality of life. Given the complexity of metastatic disease, accurate coding is essential for appropriate treatment planning and reimbursement.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Determining the primary site of cancer can be challenging.
  • Differentiating between primary and secondary malignancies requires thorough documentation.
  • Staging information must be accurately captured for treatment planning.
  • Palliative care considerations may complicate coding decisions.

Audit Risk Factors

  • Inadequate documentation of the primary cancer site.
  • Failure to document staging information.
  • Misclassification of primary versus secondary malignancies.
  • Lack of clarity in treatment plans related to palliative care.

Specialty Focus

Medical Specialties

Oncology

Documentation Requirements

Detailed documentation of the primary cancer site, staging, and treatment plans.

Common Clinical Scenarios

Patients with known primary cancers presenting with urinary symptoms.

Billing Considerations

Ensure clear differentiation between primary and secondary tumors in documentation.

Urology

Documentation Requirements

Comprehensive notes on urinary symptoms, imaging results, and biopsy findings.

Common Clinical Scenarios

Patients with hematuria or urinary obstruction due to metastatic disease.

Billing Considerations

Document any interventions performed and their outcomes.

Coding Guidelines

Inclusion Criteria

Use C79.1 When
  • According to the official coding guidelines, C79
  • 1 should be used when there is clear documentation of a secondary malignant neoplasm affecting the bladder or other urinary organs
  • Coders must ensure that the primary site of cancer is documented and that staging information is included when applicable

Exclusion Criteria

Do NOT use C79.1 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

88305CPT Code

Pathology examination of tissue

Clinical Scenario

Used when biopsy of urinary organs is performed to confirm metastatic disease.

Documentation Requirements

Pathology report must be included in the patient's medical record.

Specialty Considerations

Oncologists and urologists should ensure that biopsy results are clearly documented.

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. C79.1 provides a clear distinction for coders to identify metastatic disease affecting the urinary organs.

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. C79.1 provides a clear distinction for coders to identify metastatic disease affecting the urinary organs.

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. C79.1 provides a clear distinction for coders to identify metastatic disease affecting the urinary organs.

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 C79.1 accurately?

Accurate coding of C79.1 is crucial for appropriate treatment planning, reimbursement, and cancer registry reporting. It ensures that patients receive the correct care based on their metastatic disease status.