ICD-10 Coding for Right Breast Carcinoma(C50.411, C79.51)
Complete ICD-10-CM coding and documentation guide for Right Breast Carcinoma. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Right Breast Carcinoma
C50.0-C50.9Primary Range
Malignant neoplasm of breast
This range includes all codes related to malignant neoplasms of the breast, specifying laterality and site.
Estrogen receptor status
Used to indicate the estrogen receptor status of the breast carcinoma.
Secondary malignant neoplasm of other sites
Used for coding metastasis from the primary breast 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 |
|---|---|---|---|
| C50.411 | Malignant neoplasm of upper-outer quadrant of right female breast | Use when the tumor is located in the upper-outer quadrant of the right breast. |
|
| C79.51 | Secondary malignant neoplasm of bone | Use when there is confirmed metastasis to the bone from a primary breast carcinoma. |
|
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 right breast carcinoma
Essential facts and insights about Right Breast Carcinoma
Primary ICD-10-CM Codes for right breast carcinoma
Decision Criteria
clinical Criteria
- Confirmed malignancy in specified quadrant via imaging or biopsy.
documentation Criteria
- Documentation must include laterality and specific quadrant.
Applicable To
- Invasive ductal carcinoma of upper-outer quadrant
Excludes
- Benign neoplasm of breast (D24.-)
Clinical Validation Requirements
- Biopsy confirming malignancy
- Imaging showing tumor location
Code-Specific Risks
- Incorrect laterality documentation
- Omission of quadrant specification
Coding Notes
- Ensure documentation specifies the exact quadrant and laterality.
C79.51 - Secondary malignant neoplasm of bone
Use when there is confirmed metastasis to the bone from a primary breast carcinoma.
Applicable To
- Metastatic bone cancer
Excludes
- Primary bone cancer (C40.-)
Clinical Validation Requirements
- CT or PET scan showing bone lesions
- Elevated alkaline phosphatase levels
Coding Notes
Ensure correct sequencing when coding for treatment of metastasis.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Estrogen receptor positive status
Z17.0Differential 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 Right Breast Carcinoma to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code C50.411.
Impact
Clinical: Affects treatment planning and outcomes., Regulatory: Non-compliance with documentation standards., Financial: Potential for reduced reimbursement.
Mitigation Strategy
Ensure ER status is documented in pathology reports., Use templates that prompt for ER status.
Impact
Reimbursement: May lead to denied claims or reduced reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Decreases accuracy of health records.
Mitigation Strategy
Always use the most specific code available, such as C50.411 for upper-outer quadrant.
Impact
Errors in documenting the correct side of the breast.
Mitigation Strategy
Implement double-checks in EHR for laterality.
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 Right Breast Carcinoma, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Right Breast Carcinoma
Use these documentation templates to ensure complete and accurate documentation for Right Breast Carcinoma. These templates include all required elements for proper coding and billing.
Breast cancer surgery note
Specialty: Surgical OncologyRequired Elements
- Tumor location and size
- Laterality and quadrant
- Histology type
- Surgical margins
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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