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 CodesC79.81

C79.81

Billable

Secondary malignant neoplasm of breast

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

Code Description

ICD-10 C79.81 is a billable code used to indicate a diagnosis of secondary malignant neoplasm of breast.

Key Diagnostic Point:

C79.81 refers to a secondary malignant neoplasm of the breast, indicating that cancer has metastasized to the breast tissue from a primary site elsewhere in the body. This condition is often associated with advanced stages of cancer, where the primary tumor may be unknown or previously treated. The breast tissue becomes a site for secondary tumors, which can lead to various symptoms, including pain, swelling, and changes in breast appearance. The management of secondary malignant neoplasms often involves palliative care, focusing on symptom relief and quality of life rather than curative treatment. Staging of metastatic breast cancer is crucial for determining the extent of disease and guiding treatment options. The presence of secondary malignancies can complicate the clinical picture, necessitating a multidisciplinary approach to care, including oncologists, radiologists, and palliative care specialists.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Determining the primary site of cancer when it is unknown.
  • Accurate staging of metastatic disease.
  • Differentiating between primary and secondary breast cancer.
  • Documentation of palliative care measures.

Audit Risk Factors

  • Inadequate documentation of the primary cancer site.
  • Failure to document staging details.
  • Misclassification of primary versus secondary tumors.
  • Lack of palliative care documentation.

Specialty Focus

Medical Specialties

Oncology

Documentation Requirements

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

Common Clinical Scenarios

Patients with known primary cancers presenting with new breast lesions.

Billing Considerations

Ensure clarity in distinguishing between primary breast cancer and metastatic disease.

Palliative Care

Documentation Requirements

Comprehensive symptom management plans and goals of care discussions.

Common Clinical Scenarios

Patients with advanced cancer requiring symptom relief and quality of life considerations.

Billing Considerations

Documentation should reflect the focus on palliative measures and patient preferences.

Coding Guidelines

Inclusion Criteria

Use C79.81 When
  • According to ICD
  • 10 guidelines, C79
  • 81 should be used when there is clear documentation of metastatic disease to the breast from a known or unknown primary site
  • Coders should ensure that the primary cancer is documented, and staging is accurately reflected in the medical record

Exclusion Criteria

Do NOT use C79.81 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

77067CPT Code

Breast MRI

Clinical Scenario

Used for imaging in patients with suspected metastatic disease.

Documentation Requirements

Indication for MRI and findings related to metastatic disease.

Specialty Considerations

Oncologists should ensure imaging results are clearly linked to the diagnosis.

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. C79.81 provides a clear distinction for metastatic disease to the breast, which aids in clinical decision-making and resource allocation.

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. C79.81 provides a clear distinction for metastatic disease to the breast, which aids in clinical decision-making and resource allocation.

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. C79.81 provides a clear distinction for metastatic disease to the breast, which aids in clinical decision-making 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 is the difference between primary and secondary malignant neoplasm of the breast?

Primary malignant neoplasm of the breast originates in the breast tissue, while secondary malignant neoplasm indicates that cancer has spread to the breast from another primary site in the body. Accurate coding requires clear documentation of the primary cancer.