ICD-10 Coding for Pelvic Mass(N83.0, C56.1)
Complete ICD-10-CM coding and documentation guide for Pelvic Mass. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Pelvic Mass
N83.0-N83.9Primary Range
Noninflammatory disorders of ovary, fallopian tube and broad ligament
Covers various types of ovarian and adnexal masses, including cysts and benign tumors.
Benign neoplasm of ovary
Applicable for benign ovarian tumors identified during evaluation of a pelvic mass.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| N83.0 | Noninflammatory disorder of ovary, unspecified | Use when imaging confirms a noninflammatory ovarian disorder without specific type. |
|
| C56.1 | Malignant neoplasm of right ovary | Use when malignancy is confirmed in the right ovary. |
|
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 pelvic mass
Essential facts and insights about Pelvic Mass
Primary ICD-10-CM Codes for pelvic mass
Decision Criteria
clinical Criteria
- Presence of a noninflammatory ovarian cyst on imaging
Applicable To
- Ovarian cyst, unspecified
Excludes
- Malignant neoplasm of ovary (C56.-)
Clinical Validation Requirements
- Ultrasound showing anechoic cyst <5 cm
- Normal CA-125 level
Code-Specific Risks
- Risk of undercoding if malignancy is suspected but not confirmed.
Coding Notes
- Ensure imaging and lab results are documented to support the diagnosis.
C56.1 - Malignant neoplasm of right ovary
Use when malignancy is confirmed in the right ovary.
Applicable To
- Ovarian cancer, right
Excludes
- Benign neoplasm of ovary (D27.-)
Clinical Validation Requirements
- Histopathology confirming adenocarcinoma
- CT showing peritoneal involvement
Coding Notes
Ensure documentation includes histopathology results.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Pelvic Mass to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code N83.0.
Impact
Clinical: May lead to inappropriate treatment decisions., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims due to insufficient documentation.
Mitigation Strategy
Ensure imaging reports are included in the patient's record, Verify documentation before claim submission
Impact
Reimbursement: May lead to reduced reimbursement due to lack of specificity., Compliance: Non-compliance with coding guidelines., Data Quality: Decreases accuracy of health records.
Mitigation Strategy
Specify laterality and type based on imaging and histopathology.
Impact
High risk of audit for using unspecified codes without supporting documentation.
Mitigation Strategy
Ensure all documentation specifies laterality and type of mass.
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 Pelvic Mass, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Pelvic Mass
Use these documentation templates to ensure complete and accurate documentation for Pelvic Mass. These templates include all required elements for proper coding and billing.
Evaluation of a suspected ovarian cyst
Specialty: GynecologyRequired Elements
- Patient history
- Bimanual exam findings
- Imaging results
- Plan for follow-up or intervention
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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