Metastatic Breast Cancer ICD-10-CM Codes
Understand ICD-10 codes for metastatic breast cancer, their role in medical billing, and the critical clinical information they represent.
Fact Checked by Ericka Pingol.
What ICD-10 Codes are Used for Metastatic Breast Cancer?
Metastatic breast cancer, also known as stage IV or advanced breast cancer, is a condition where cancer has spread from the breast to other parts of the body. This stage of breast cancer is complex and requires specific ICD-10 codes for accurate documentation and billing. Here are some commonly used ICD-10 codes for metastatic breast cancer:
- C79.81 - Secondary malignant neoplasm of the breast: This code is used when cancer originating from another body part has spread to the breast.
- C50.911 - Malignant neoplasm of unspecified site of the right female breast: This code is used when the specific location of cancer in the right breast is not identified.
- C50.912 - Malignant neoplasm of unspecified site of the left female breast: Similar to the previous code but refers to cancer in the left breast.
- C50.819 - Malignant neoplasm of overlapping sites of the unspecified female breast: This code is used when cancer has spread to multiple areas of the breast, but the exact locations are not specified.
- C80.1 - Disseminated malignant neoplasm, unspecified: This code is used when cancer has spread throughout the body, but the primary origin of the cancer is not known.
- C78.01 - Secondary malignant neoplasm of the lung: This code is used when breast cancer has metastasized to the lungs.
- C78.7 - Secondary malignant neoplasm of the liver and intrahepatic bile duct: This code is used when breast cancer has metastasized to the liver.
- C79.51 - Secondary malignant neoplasm of bone: This code is used when breast cancer has spread to the bones.
- C79.31 - Secondary malignant neoplasm of brain and cerebral meninges: This code is used when breast cancer has metastasized to the brain.
- C79.40 - Secondary malignant neoplasm of the unspecified kidney: This code is used when breast cancer has spread to the kidneys, but the specific kidney is not identified.
You can watch this explainer video for a more detailed understanding of these codes.
For more information on medical billing and coding, particularly regarding metastatic breast cancer, visit our Metastatic Breast Cancer ICD Codes page on CarePatron.
Which Metastatic Breast Cancer ICD codes are Billable?
Here's a rundown of commonly used metastatic breast cancer ICD-10 codes and whether they are billable:
- C79.81 - Secondary malignant neoplasm of the breast: Yes, this code is billable.
- C50.911 - Malignant neoplasm of unspecified site of the right female breast: Yes, this code is billable.
- C50.912 - Malignant neoplasm of unspecified site of the left female breast: Yes, this code is billable.
- C50.819 - Malignant neoplasm of overlapping sites of the unspecified female breast: Yes, this code is billable.
- C80.1 - Disseminated malignant neoplasm, unspecified: Yes, this code is billable.
- C78.01 - Secondary malignant neoplasm of the lung: Yes, this code is billable.
- C78.7 - Secondary malignant neoplasm of the liver and intrahepatic bile duct: Yes, this code is billable.
- C79.51 - Secondary malignant neoplasm of bone: Yes, this code is billable.
- C79.31 - Secondary malignant neoplasm of brain and cerebral meninges: Yes, this code is billable.
- C79.40 - Secondary malignant neoplasm of the unspecified kidney: Yes, this code is billable.
While these codes are typically billable, the specifics may depend on the individual healthcare provider's billing practices and the patient's insurance plan. Always consult with a billing specialist or the insurance provider for confirmation.
Commonly asked questions
An ICD code for metastatic breast cancer is used when cancer has spread from the breast to other body parts, such as the bones, lungs, liver, or brain. Healthcare providers use these codes for documentation, billing, and statistical purposes.
Yes, diagnoses for metastatic breast cancer are typically billable. However, the specifics may depend on the individual healthcare provider's billing practices and the patient's insurance plan. Always consult with a billing specialist or the insurance provider for confirmation.
Treatment for metastatic breast cancer is usually systemic, which targets cancer cells throughout the body. Options may include hormone therapy, chemotherapy, targeted therapy, immunotherapy, or a combination. Treatment choice depends on several factors, including the type of primary breast cancer, the extent of metastasis, previous treatments, and the patient's overall health.
