ICD-10 Coding for Infiltrating Ductal Carcinoma(C50.211, C50.212)
Complete ICD-10-CM coding and documentation guide for Infiltrating Ductal Carcinoma. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Infiltrating Ductal Carcinoma
C50.0-C50.9Primary Range
Malignant neoplasm of breast
This range includes all codes related to breast cancer, including specific quadrants and laterality for IDC.
Secondary malignant neoplasm of bone
Used to code for metastatic sites related to primary breast cancer.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| C50.211 | Malignant neoplasm of upper-inner quadrant of right female breast | Use when IDC is confirmed in the upper-inner quadrant of the right breast. |
|
| C50.212 | Malignant neoplasm of upper-inner quadrant of left female breast | Use when IDC is confirmed in the upper-inner quadrant of the left breast. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for infiltrating ductal carcinoma
Essential facts and insights about Infiltrating Ductal Carcinoma
Primary ICD-10-CM Codes for infiltrating ductal carcinoma
Decision Criteria
documentation Criteria
- Quadrant and laterality must be documented.
Applicable To
- Infiltrating ductal carcinoma of the upper-inner quadrant
Excludes
- Benign neoplasm of breast
Clinical Validation Requirements
- Biopsy confirming IDC
- Imaging showing mass in specified quadrant
Code-Specific Risks
- Incorrect laterality documentation
- Unspecified quadrant leading to incorrect coding
Coding Notes
- Ensure documentation specifies both quadrant and laterality to avoid unspecified codes.
C50.212 - Malignant neoplasm of upper-inner quadrant of left female breast
Use when IDC is confirmed in the upper-inner quadrant of the left breast.
Applicable To
- Infiltrating ductal carcinoma of the upper-inner quadrant
Excludes
- Benign neoplasm of breast
Clinical Validation Requirements
- Biopsy confirming IDC
- Imaging showing mass in specified quadrant
Coding Notes
Ensure documentation specifies both quadrant and laterality to avoid unspecified codes.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Secondary malignant neoplasm of bone
C79.51Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Infiltrating Ductal Carcinoma to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code C50.211.
Impact
Clinical: May affect treatment decisions and outcomes., Regulatory: Non-compliance with coding standards., Financial: Potential for claim denials or reduced reimbursement.
Mitigation Strategy
Ensure receptor status is included in pathology reports, Train staff on importance of complete documentation
Impact
Reimbursement: Potential for reduced reimbursement due to lack of specificity., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Decreased accuracy in clinical data reporting.
Mitigation Strategy
Always code to the highest level of specificity available in the documentation.
Impact
High risk of audit if unspecified codes are used when specific documentation is available.
Mitigation Strategy
Implement regular documentation audits to ensure specificity.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Infiltrating Ductal Carcinoma, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Infiltrating Ductal Carcinoma
Use these documentation templates to ensure complete and accurate documentation for Infiltrating Ductal Carcinoma. These templates include all required elements for proper coding and billing.
Pathology report for IDC
Specialty: OncologyRequired Elements
- Histologic type
- Tumor size
- Grade
- Margins
- Receptor status
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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