ICD-10 Coding for Renal Lesion(C64.1, D30.01)
Complete ICD-10-CM coding and documentation guide for Renal Lesion. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Renal Lesion
C64-C65Primary Range
Malignant neoplasms of kidney and renal pelvis
Primary range for coding malignant renal lesions, including renal cell carcinoma.
Benign neoplasms and neoplasms of uncertain or unknown behavior of urinary organs
Used for benign renal lesions and those with uncertain behavior.
Abnormal findings on diagnostic imaging of body structures
Used for incidental findings of renal lesions on imaging.
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 a biopsy confirms malignancy in the right kidney. |
|
| D30.01 | Benign neoplasm of right kidney | Use when a biopsy confirms a benign lesion in the right kidney. |
|
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 malignant renal lesion
Essential facts and insights about Renal Lesion
Primary ICD-10-CM Codes for renal lesion
Decision Criteria
clinical Criteria
- Biopsy confirms malignant neoplasm
documentation Criteria
- Imaging shows enhancement >20 HU
Applicable To
- Clear cell renal cell carcinoma
- Papillary renal cell carcinoma
Excludes
- Malignant neoplasm of renal pelvis (C65.X)
Clinical Validation Requirements
- Biopsy confirming malignancy
- Imaging showing enhancement >20 HU
Code-Specific Risks
- Incorrect laterality coding
- Missing biopsy confirmation
Coding Notes
- Ensure laterality is specified and biopsy results are documented.
D30.01 - Benign neoplasm of right kidney
Use when a biopsy confirms a benign lesion in the right kidney.
Applicable To
- Oncocytoma
- Angiomyolipoma
Excludes
- Malignant neoplasm of kidney (C64.X)
Clinical Validation Requirements
- Biopsy confirming benign nature
- Imaging showing non-enhancing lesion
Coding Notes
Ensure biopsy results confirm benign nature before coding.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Abnormal findings on diagnostic imaging of urinary organs
R93.4Differential 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 Renal Lesion to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code C64.1.
Impact
Clinical: Leads to incorrect diagnosis and treatment plans., Regulatory: Non-compliance with documentation standards., Financial: May result in claim denials or reduced reimbursement.
Mitigation Strategy
Ensure biopsy results are included in the patient's record., Cross-check biopsy documentation before coding.
Impact
Reimbursement: Incorrect coding can lead to claim denials., Compliance: Non-compliance with coding guidelines., Data Quality: Impacts accuracy of patient records.
Mitigation Strategy
Always verify and document the side of the kidney affected.
Impact
Reimbursement: May affect DRG assignment and payment., Compliance: Non-compliance with specificity requirements., Data Quality: Reduces the quality of clinical data.
Mitigation Strategy
Ensure documentation supports the use of specific codes.
Impact
Incorrect laterality coding can lead to audit flags.
Mitigation Strategy
Implement a checklist to verify laterality in all renal lesion 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 Lesion, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Renal Lesion
Use these documentation templates to ensure complete and accurate documentation for Renal Lesion. These templates include all required elements for proper coding and billing.
Documenting a renal lesion found on imaging
Specialty: RadiologyRequired Elements
- Location of lesion
- Size and enhancement characteristics
- Biopsy results if available
- Management recommendations
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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