ICD-10 Coding for Renal Cell Carcinoma(C64.1, C64.2, C64.9)
Complete ICD-10-CM coding and documentation guide for Renal Cell Carcinoma. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Renal Cell Carcinoma
C64-C65Primary Range
Malignant neoplasm of kidney, except renal pelvis
This range includes codes for renal cell carcinoma, specifying laterality and unspecified cases.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| C64.1 | Malignant neoplasm of right kidney, except renal pelvis | Use when documentation specifies right kidney involvement. |
|
| C64.2 | Malignant neoplasm of left kidney, except renal pelvis | Use when documentation specifies left kidney involvement. |
|
| C64.9 | Malignant neoplasm of unspecified kidney, except renal pelvis | Use when laterality is not documented. |
|
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 renal cell carcinoma
Essential facts and insights about Renal Cell Carcinoma
Primary ICD-10-CM Codes for renal cell carcinoma
Decision Criteria
clinical Criteria
- Right kidney tumor confirmed by imaging and biopsy
Applicable To
- Right kidney RCC
Excludes
- Malignant neoplasm of renal pelvis (C65.1)
Clinical Validation Requirements
- Imaging/pathology confirming right-sided tumor
- Biopsy results indicating clear cell carcinoma
Code-Specific Risks
- Risk of unspecified laterality if not documented
Coding Notes
- Ensure laterality is documented to avoid unspecified coding.
C64.2 - Malignant neoplasm of left kidney, except renal pelvis
Use when documentation specifies left kidney involvement.
Applicable To
- Left kidney RCC
Excludes
- Malignant neoplasm of renal pelvis (C65.2)
Clinical Validation Requirements
- Imaging/pathology confirming left-sided tumor
- Biopsy results indicating clear cell carcinoma
Coding Notes
Ensure laterality is documented to avoid unspecified coding.
C64.9 - Malignant neoplasm of unspecified kidney, except renal pelvis
Use when laterality is not documented.
Applicable To
- Unspecified kidney RCC
Excludes
- Malignant neoplasm of renal pelvis (C65.9)
Clinical Validation Requirements
- Imaging/pathology confirming kidney tumor without specified laterality
Coding Notes
Query for laterality to avoid unspecified coding.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Secondary malignant neoplasm of lung
C78.0Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Malignant neoplasm of right renal pelvis
C65.1Malignant neoplasm of left renal pelvis
C65.2Malignant neoplasm of unspecified renal pelvis
C65.9Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Renal Cell Carcinoma to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code C64.1.
Impact
Clinical: May lead to inappropriate treatment plans., Regulatory: Increased risk of audits and compliance issues., Financial: Potential for reduced reimbursement.
Mitigation Strategy
Ensure pathology reports specify histologic subtype.
Impact
Reimbursement: Potential for reduced reimbursement due to unspecified coding., Compliance: Increased audit risk and potential compliance issues., Data Quality: Decreased data quality and specificity.
Mitigation Strategy
Query the provider for laterality to ensure accurate coding.
Impact
High audit risk due to unspecified laterality in renal cell carcinoma coding.
Mitigation Strategy
Ensure documentation specifies laterality in all cases.
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 Renal Cell Carcinoma, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Renal Cell Carcinoma
Use these documentation templates to ensure complete and accurate documentation for Renal Cell Carcinoma. These templates include all required elements for proper coding and billing.
Imaging Report for Renal Mass
Specialty: RadiologyRequired Elements
- Tumor location
- Tumor size
- Enhancement pattern
- Local invasion
- Metastases
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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