ICD-10 Coding for Paget's Disease(C50.011, M88.0)
Complete ICD-10-CM coding and documentation guide for Paget's Disease. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Paget's Disease
Malignant neoplasm of breast
Used for coding mammary Paget's disease with underlying carcinoma.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| C50.011 | Malignant neoplasm of nipple and areola, female, right breast | Use when mammary Paget's disease is confirmed with underlying carcinoma. |
|
| M88.0 | Paget's disease of bone, skull | Use for Paget's disease affecting the skull. |
|
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 Paget's disease of bone
Essential facts and insights about Paget's Disease
Primary ICD-10-CM Codes for paget's disease
Decision Criteria
clinical Criteria
- Presence of Paget cells and underlying carcinoma
Applicable To
- Mammary Paget's disease with underlying carcinoma
Excludes
- Benign neoplasm of breast
Clinical Validation Requirements
- Biopsy showing Paget cells
- HER2+ tumor cells on biopsy
Code-Specific Risks
- Incorrect laterality coding
Coding Notes
- Ensure documentation specifies laterality and underlying carcinoma.
M88.0 - Paget's disease of bone, skull
Use for Paget's disease affecting the skull.
Applicable To
- Paget's disease of skull
Excludes
- Osteoporosis
Clinical Validation Requirements
- Elevated serum ALP
- Lytic-blastic lesions on X-ray
Coding Notes
Document specific bone involvement and any complications.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
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 Paget's Disease to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code C50.011.
Impact
Clinical: Inaccurate representation of patient's condition., Regulatory: Non-compliance with coding standards., Financial: Potential for denied claims.
Mitigation Strategy
Review biopsy results for underlying malignancy, Ensure documentation includes all relevant details
Impact
Reimbursement: May lead to denied claims due to lack of specificity., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data affecting patient records.
Mitigation Strategy
Ensure documentation specifies right or left breast.
Impact
Failure to specify laterality in breast cancer coding.
Mitigation Strategy
Implement a checklist for documentation review.
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 Paget's Disease, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Paget's Disease
Use these documentation templates to ensure complete and accurate documentation for Paget's Disease. These templates include all required elements for proper coding and billing.
Mammary Paget's Disease with Underlying Carcinoma
Specialty: OncologyRequired Elements
- Biopsy results
- HER2 status
- Laterality
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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