ICD-10 Coding for Urothelial Cancer(C67.0, C67.2)
Complete ICD-10-CM coding and documentation guide for Urothelial Cancer. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Urothelial Cancer
C67.0-C67.9Primary Range
Malignant neoplasm of bladder
This range covers all primary malignant neoplasms of the bladder, including specific locations such as the trigone, dome, and lateral wall.
Personal history of malignant neoplasm of bladder
Used for patients with a history of bladder cancer after curative treatment.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| C67.0 | Malignant neoplasm of trigone of bladder | Use when the tumor is located at the trigone of the bladder. |
|
| C67.2 | Malignant neoplasm of lateral wall of bladder | Use when the tumor is located on the lateral wall of the bladder. |
|
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 urothelial cancer
Essential facts and insights about Urothelial Cancer
Primary ICD-10-CM Codes for urothelial cancer
Decision Criteria
clinical Criteria
- Tumor confirmed at trigone via imaging or biopsy.
Applicable To
- Cancer of the trigone of the bladder
Excludes
- Benign neoplasm of bladder (D30.3)
Clinical Validation Requirements
- Pathology report confirming urothelial carcinoma
- Imaging showing tumor at trigone
Code-Specific Risks
- Misidentifying tumor location can lead to incorrect coding.
Coding Notes
- Ensure precise documentation of tumor location.
C67.2 - Malignant neoplasm of lateral wall of bladder
Use when the tumor is located on the lateral wall of the bladder.
Applicable To
- Cancer of the lateral wall of the bladder
Excludes
- Benign neoplasm of bladder (D30.3)
Clinical Validation Requirements
- Biopsy confirms urothelial carcinoma involving lateral wall
Coding Notes
Document specific tumor location and histology.
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 Urothelial Cancer to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code C67.0.
Impact
Clinical: May affect treatment decisions., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims due to insufficient documentation.
Mitigation Strategy
Ensure histologic grade is documented in all pathology reports.
Impact
Reimbursement: May lead to lower reimbursement rates., Compliance: Non-compliance with coding guidelines., Data Quality: Reduces accuracy of clinical data.
Mitigation Strategy
Always use the most specific code available based on documentation.
Impact
Audits may focus on the specificity of tumor location in documentation.
Mitigation Strategy
Train staff on the importance of documenting precise tumor locations.
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 Urothelial Cancer, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Urothelial Cancer
Use these documentation templates to ensure complete and accurate documentation for Urothelial Cancer. These templates include all required elements for proper coding and billing.
Diagnosis of Bladder Cancer
Specialty: UrologyRequired Elements
- Tumor location
- Histologic grade
- Depth of invasion
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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