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ICD-10 Guide
ICD-10 CodesC79.19

C79.19

Billable

Secondary malignant neoplasm of other urinary organs

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

Code Description

ICD-10 C79.19 is a billable code used to indicate a diagnosis of secondary malignant neoplasm of other urinary organs.

Key Diagnostic Point:

C79.19 refers to secondary malignant neoplasms that have metastasized to other urinary organs, excluding the bladder and kidney. This code is used when a primary cancer from another site has spread to the urinary system, which may include the ureters, urethra, or other associated structures. The clinical presentation can vary widely, with symptoms often depending on the site of metastasis and the extent of disease. Common symptoms may include hematuria, urinary obstruction, or renal impairment. Accurate staging is crucial, as it influences treatment decisions and prognosis. In cases where the primary tumor is unknown, thorough diagnostic workup is essential to identify the origin of the malignancy. Palliative care considerations are significant, focusing on symptom management and quality of life, especially in advanced stages of metastatic disease. This code is vital for capturing the complexity of metastatic cancer in the urinary system and ensuring appropriate treatment and management strategies are employed.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Determining the primary site of cancer can be challenging.
  • Need for accurate staging to guide treatment.
  • Differentiating between primary and secondary tumors.
  • Documentation of symptoms and clinical findings is critical.

Audit Risk Factors

  • Inadequate documentation of the primary cancer site.
  • Failure to document staging information.
  • Misidentification of the urinary organ involved.
  • Lack of clarity in the clinical narrative regarding metastasis.

Specialty Focus

Medical Specialties

Oncology

Documentation Requirements

Detailed history of the primary cancer, staging information, and treatment plans.

Common Clinical Scenarios

Patients with known primary cancers presenting with urinary symptoms.

Billing Considerations

Ensure clear documentation of the metastatic process and any treatments administered.

Urology

Documentation Requirements

Clinical findings, imaging results, and any surgical interventions performed.

Common Clinical Scenarios

Patients with urinary obstruction due to metastatic disease.

Billing Considerations

Document the specific urinary organ affected and any related complications.

Coding Guidelines

Inclusion Criteria

Use C79.19 When
  • According to ICD
  • 10 coding guidelines, C79
  • 19 should be used when there is clear documentation of a secondary malignant neoplasm in the urinary organs
  • It is important to ensure that the primary site of cancer is documented, and staging information is included to support the use of this code

Exclusion Criteria

Do NOT use C79.19 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

88305CPT Code

Pathology examination of tissue

Clinical Scenario

Used when a biopsy is performed to confirm metastatic disease.

Documentation Requirements

Pathology report indicating malignancy and origin.

Specialty Considerations

Oncologists and pathologists must collaborate for accurate diagnosis.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of metastatic diseases, improving the accuracy of data collection and reimbursement processes. C79.19 provides a clear distinction for secondary malignancies in the urinary system, which was less defined in ICD-9.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of metastatic diseases, improving the accuracy of data collection and reimbursement processes. C79.19 provides a clear distinction for secondary malignancies in the urinary system, which was less defined in ICD-9.

Reimbursement & Billing Impact

reimbursement processes. C79.19 provides a clear distinction for secondary malignancies in the urinary system, which was less defined in ICD-9.

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 C79.19 accurately?

Accurate coding of C79.19 is crucial for proper treatment planning, resource allocation, and ensuring that patients receive appropriate palliative care. It also impacts data collection for cancer registries and research.