ICD-10 Coding for Ovarian Tumor(C56.1, C56.2, C56.3, C79.63)
Complete ICD-10-CM coding and documentation guide for Ovarian Tumor. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Ovarian Tumor
C56-C57Primary Range
Malignant neoplasms of ovary and other uterine adnexa
This range includes primary malignant neoplasms of the ovary, which are the most clinically significant codes for ovarian tumors.
Secondary malignant neoplasm of ovary
This range is used for coding metastatic ovarian cancer, indicating a secondary site of malignancy.
Neoplasm of uncertain behavior of ovary
This range is used for coding ovarian tumors with uncertain behavior, pending further histological confirmation.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| C56.1 | Malignant neoplasm of right ovary | Use when malignancy is confirmed in the right ovary. |
|
| C56.2 | Malignant neoplasm of left ovary | Use when malignancy is confirmed in the left ovary. |
|
| C56.3 | Malignant neoplasm of bilateral ovaries | Use when malignancy is confirmed in both ovaries. |
|
| C79.63 | Secondary malignant neoplasm of bilateral ovaries | Use when ovarian cancer is secondary to another primary site. |
|
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 ovarian cancer
Essential facts and insights about Ovarian Tumor
Primary ICD-10-CM Codes for ovarian tumor
Decision Criteria
clinical Criteria
- Confirmed right ovarian mass with malignant features
Applicable To
- Primary ovarian cancer, right side
Excludes
- Secondary ovarian cancer (C79.6)
Clinical Validation Requirements
- Imaging confirmation of right ovarian mass
- Histopathological confirmation of malignancy
Code-Specific Risks
- Incorrect laterality documentation
Coding Notes
- Ensure laterality is documented in the medical record.
C56.2 - Malignant neoplasm of left ovary
Use when malignancy is confirmed in the left ovary.
Applicable To
- Primary ovarian cancer, left side
Excludes
- Secondary ovarian cancer (C79.6)
Clinical Validation Requirements
- Imaging confirmation of left ovarian mass
- Histopathological confirmation of malignancy
Coding Notes
Ensure laterality is documented in the medical record.
C56.3 - Malignant neoplasm of bilateral ovaries
Use when malignancy is confirmed in both ovaries.
Applicable To
- Primary ovarian cancer, bilateral
Excludes
- Secondary ovarian cancer (C79.6)
Clinical Validation Requirements
- Imaging confirmation of bilateral ovarian masses
- Histopathological confirmation of malignancy
Coding Notes
Ensure bilateral involvement is documented in the medical record.
C79.63 - Secondary malignant neoplasm of bilateral ovaries
Use when ovarian cancer is secondary to another primary site.
Applicable To
- Metastatic ovarian cancer
Excludes
- Primary ovarian cancer (C56.x)
Clinical Validation Requirements
- Documentation of primary site of cancer
- Evidence of metastasis to ovaries
Coding Notes
Ensure primary site is documented and coded.
Differential 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 Ovarian Tumor to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code C56.1.
Impact
Clinical: Misleading clinical picture of cancer origin., Regulatory: Potential non-compliance with coding standards., Financial: Incorrect DRG assignment affecting reimbursement.
Mitigation Strategy
Always document and code the primary site of cancer., Use C79.63 only when primary site is confirmed.
Impact
Reimbursement: May lead to lower reimbursement rates., Compliance: Non-compliance with coding guidelines., Data Quality: Decreases accuracy of health data.
Mitigation Strategy
Ensure laterality is documented and use specific codes like C56.1 or C56.2.
Impact
Failure to document laterality can lead to incorrect coding.
Mitigation Strategy
Implement mandatory laterality checks in documentation workflows.
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 Ovarian Tumor, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Ovarian Tumor
Use these documentation templates to ensure complete and accurate documentation for Ovarian Tumor. These templates include all required elements for proper coding and billing.
Ovarian Cancer Diagnosis
Specialty: Gynecologic OncologyRequired Elements
- Patient history
- Imaging results
- Pathology report
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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