(2022) How To Code Breast Cancer ICD 10 – List With Codes & Guidelines
Breast cancer ICD 10 coding is made easier with our billing guidelines. This article includes all medical codes you will need to report breast cancer and related specific ICD 10 & 11 codes, such as invasive ductal carcinoma of the breast and breast cancer metastasis.
Read on to get a summary of the necessary codes followed by a further description.
What Is Breast Cancer?
Cancer occurs when mutations happen in the genes that control cell growth. Mutations cause cells to divide and multiply in uncontrolled ways.
Breast cancer is cancer that arises from the cells of the breast. Cancers usually form in lobules or tubes in the breast.
The lobules are the milk-producing glands, and the ducts are the pathways that supply milk from the lobular glands to the nipple. Cancer can also develop in the fatty or fibrous connective tissue of the breast.
Uncontrolled cancer cells can often invade other healthy breast tissues in the body and travel to the lymph nodes in the axilla. When cancer enters the lymph nodes, it has access to the lymphatic channels and can travel to other body parts.
Breast cancer may cause no symptoms in its early stages. The tumor is too small to feel, but mammography will reveal abnormalities in many cases.
The first sign of breast cancer usually palpates a lump in the breast that hasn’t been there before. But not all lumps are cancerous.
Each type of breast cancer may cause a variety of symptoms. Many of these symptoms are similar, but some may vary. Some of the symptoms of breast cancer may include:
A change in the size, shape, or contour of the breast.
A mass or lump may feel as small as a pea.
A lump or thickening in or near the breast or the axilla persists through your menstrual cycle.
A change in the look or feel of the skin on the breast or nipple (dimpled, puckered, scaly, or inflamed).
Redness of the skin on the breast or nipple.
An area that’s distinctly different from any other area on either breast.
A marble-like hardened area under the skin.
A blood-stained or clear fluid discharge from the nipple.
There are many types of breast cancer. Classifications are determined by specific types of cells in the breast affected by cancer.
Most breast cancer is carcinoma. Adenocarcinoma is the most common breast cancer, such as ductal carcinoma in situ (DCIS) and invasive carcinoma.
Other types of breast cancer include angiosarcoma or sarcoma. However, they are not considered breast cancer since they start in different breast cells.
Breast cancer is also classified by the specific type of protein or gene that each cancer can produce.
After a biopsy, breast cancer cells are tested for proteins called estrogen and progesterone receptors and the HER2 gene or protein.
Tumor cells are also scrutinized in the laboratory to find out what grade they are. The specific proteins and tumor grades found help determine the stage of cancer and treatment options.
Several breast cancer treatment options include surgery, chemotherapy, radiation therapy, hormone therapy, immunotherapy, and targeted drug therapy.
Breast Cancer ICD 10
Breast Cancer ICD 10 code for malignant neoplasm of the breast is C50.
It can be selected in the ICD 10 book by following these steps. First, it is located in the chapter II, which codes for Neoplasms. It is coded (C00-D49). It can be found in block C50, which codes for Malignant neoplasms of the breast. It has the following categories coded under it:
C50.0 – Malignant neoplasm of nipple and areola.
C50.1 – Malignant neoplasm of the central portion of the breast.
C50.2 – Malignant neoplasm of the upper inner quadrant of the breast.
C50.3 – Malignant neoplasm of the lower inner quadrant of the breast.
C50.4 – Malignant neoplasm of the upper-outer quadrant of the breast.
C50.5 – Malignant neoplasm of the lower outer quadrant of the breast.
C50.6 – Malignant neoplasm of axillary tail of breast.
C50.8 – Malignant neoplasm of overlapping sites of the breast.
C50.9 – Malignant neoplasm of breast of unspecified site.
Each category is further subdivided based on whether the malignant neoplasm occurs in a male or female.
For example, the ICD 10 code for Malignant neoplasm of nipple and areola in females is C50.01, while the ICD 10 code for Malignant neoplasm of nipple and areola in males is C50.02.
Likewise, the ICD 10 code for Malignant neoplasm of the lower outer quadrant of the breast is C50.51, while the ICD 10 code for Malignant neoplasm of the lower outer quadrant of the breast in males is C50.52.
History Of Breast Cancer ICD 10
The ICD 10 code for Personal history of malignant neoplasm of breast in the ICD 10 CM book is Z85.3.
It can be found in chapter XXI of the ICD 10 book, which codes for Z00-Z99 Factors influencing health status and contact with health services, Under the block Z77-Z99.
This code is for Persons with potential health hazards related to family and personal history and certain conditions influencing health status and under the category Z85 which codes for Personal history of malignant neoplasm.
Breast Cancer Screening ICD 10
Breast cancer screening ICD 10 code is Z12.31.
Z12.31 is a billable ICD 10 CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD 10 CM Z12.31 became effective on October 1, 2021.
It can be found in chapter XXI of the ICD 10 book, which is coded Z00-Z99 Factors influencing health status and contact with health services, under the block Z00-Z13 Persons encountering health services for examinations, and under the category Z12. Encounter for screening for malignant neoplasms.
Family History Of Breast Cancer ICD 10
Family history of breast cancer ICD 10 code is Z80.3.
Z80.3 is a billable/specific ICD 10 CM code that can be used to indicate a diagnosis for reimbursement purposes.
The 2022 edition of ICD 10 CM Z80.3 became effective on October 1, 2021.
It can be found in chapter XXI of the ICD 10 book, Z00-Z99 Factors influencing health status and contact with health services, under the block Z77-Z99 Persons with potential health hazards related to family and personal history and certain conditions affecting health status, and under the category Z80 Family history of primary malignant neoplasm.
Left Breast Cancer ICD 10
Left breast cancer ICD 10 codes for females include the following:
C50.012 Malignant neoplasm of nipple and areola left female breast.
C50.112 Malignant neoplasm of the central portion left female breast.
C50.212 Malignant neoplasm of the upper inner quadrant left female breast.
C50.312 Malignant neoplasm of the lower inner quadrant left female breast.
C50.412 Malignant neoplasm of the upper outer quadrant left female breast.
C50.512 Malignant neoplasm of the lower outer quadrant left female breast.
C50.612 Malignant neoplasm of the axillary tail left female breast.
C50.812 Malignant neoplasm of overlapping sites left female breast.
C50.912 Malignant neoplasm of the unspecified site left female breast.
D05.02 Lobular carcinoma in situ left breast.
D05.12 Intraductal carcinoma in situ left breast.
D05.82 Other specified types of carcinoma in situ is the left breast.
The ICD 10 code for left breast cancer for males include the following:
C50.022 Malignant neoplasm of nipple and areola left male breast.
C50.122 Malignant neoplasm of the central portion left male breast.
C50.222 Malignant neoplasm of the upper-inner quadrant left male breast.
C50.322 Malignant neoplasm of the lower-inner quadrant left male breast.
C50.422 Malignant neoplasm of the upper-outer quadrant left male breast.
C50.522 Malignant neoplasm of the lower-outer quadrant left male breast.
C50.622 Malignant neoplasm of the axillary tail left male breast.
C50.822 Malignant neoplasm of overlapping sites left male breast.
C50.922 Malignant neoplasm of the unspecified site left male breast.
D05.02 Lobular carcinoma in situ left breast.
D05.12 Intraductal carcinoma in situ left breast.
D05.82 Other specified types of carcinoma in situ is the left breast.
Right Breast Cancer ICD 10
The ICD 10 code for right breast cancer for females include the following:
C50.011 Malignant neoplasm of nipple and areola, right female breast.
C50.111 Malignant neoplasm of the central portion, right female breast.
C50.211 Malignant neoplasm of the upper inner quadrant, right female breast.
C50.311 Malignant neoplasm of the lower inner quadrant, right female breast.
C50.411 Malignant neoplasm of the upper outer quadrant, right female breast.
C50.511 Malignant neoplasm of the lower outer quadrant, right female breast.
C50.611 Malignant neoplasm of the axillary tail, right female breast.
C50.811 Malignant neoplasm of overlapping sites, right female breast.
C50.911 Malignant neoplasm of unspecified site, right female breast.
D05.01 Lobular carcinoma in situ, right breast.
D05.11 Intraductal carcinoma in situ, right breast.
D05.81 Other specified types of carcinoma in situ, right breast.
The ICD 10 code for right breast cancer for males include the following:
C50.021 Malignant neoplasm of nipple and areola, right male breast.
C50.121 Malignant neoplasm of the central portion, right male breast.
C50.221 Malignant neoplasm of the upper inner quadrant, right male breast.
C50.321 Malignant neoplasm of the lower inner quadrant, right male breast.
C50.421 Malignant neoplasm of the upper outer quadrant, right male breast.
C50.521 Malignant neoplasm of the lower outer quadrant, right male breast.
C50.621 Malignant neoplasm of the axillary tail, right male breast.
C50.821 Malignant neoplasm of overlapping sites, right male breast.
C50.921 Malignant neoplasm of unspecified site, right male breast.
D05.01 Lobular carcinoma in situ, right breast.
D05.11 Intraductal carcinoma in situ, right breast.
D05.81 Other specified types of carcinoma in situ, right breast.
Metastatic Breast Cancer ICD 10
Metastatic breast cancer occurs when the breast cancer cells have spread to other parts of the body.
Accurate sequencing for primary and secondary cancer depends on which site is being treated or focused upon at the current encounter.
For instance, a patient who has primary breast cancer (C50.xx) who is now seen for metastatic bone cancer will have a code for the secondary bone cancer (C79.51) sequenced before a code for the primary breast cancer (C50.xx).
The general code for secondary malignant neoplasm can be seen from C77-C79.
Invasive Ductal Carcinoma Breast Cancer ICD 10
Invasive ductal carcinoma breast cancer ICD 10 in situ of the unspecified breast is D05.10.
D05.10 is a billable/specific ICD 10 CM code that can be used to indicate a diagnosis for reimbursement purposes.
The 2022 edition of ICD 10 CM D05.10 became effective on October 1, 2021.
It can be found in chapter ii C00-D49 which codes for Neoplasms, in the block D00-D09, which codes for In situ neoplasms, and under the category D05, which codes for carcinoma in situ in the breast.
The Approximate Synonyms include:
- Cancer of the breast, ductal carcinoma in situ
- Intraductal carcinoma in situ of the breast
Breast Cancer In Remission ICD 10
The National Cancer Institute defines remission as:
“A decrease in or disappearance of signs or symptoms of cancer. Partial remission, some but not all signs and symptoms of cancer have disappeared. Complete remission, all signs and symptoms of cancer have disappeared, although cancer still may be in the body.”
Some providers say that aromatase inhibitors and tamoxifen therapy are applied during the complete remission of invasive breast cancer to prevent invasive cancer from recurring or distant metastasis.
However, cancer still may be in the body.
In remission generally is coded as current, as long as there is no contradictory information elsewhere in the record.
Thus, breast cancer in remission will be coded as C50.
Genetic Predisposition To Breast Cancer ICD 10
Genetic predisposition to breast cancer ICD 10 code is Z15.01.
It can be found in chapter XXI of the ICD 10 book Z00-Z99 Factors influencing health status and contact with health services under the block Z15 Genetic susceptibility to disease, and under the category Z15.0 Genetic susceptibility to malignant neoplasm.
Stage 4 Breast Cancer ICD 10
Stage 4 breast cancer ICD 10 is the same code as metastatic breast cancer (C77-C79).
ICD 10 Code For Right Upper Inner Quadrant Breast Cancer
The ICD 10 code for right upper inner quadrant breast cancer is C50.211 (Malignant neoplasm of the upper inner quadrant, right female breast).
C50.221 is the ICD 10 code for Malignant neoplasm of the upper inner quadrant, right male breast.
Metaplastic Breast Cancer ICD 10
Metaplastic carcinoma of the breast is a rare, aggressive subtype of invasive breast carcinoma characterized by rapid growth, relatively large tumor size, and a tendency to metastasize to distant organs, particularly the lungs, with less frequent involvement axillary lymph nodes.
The ICD 10 code include: C50.0, C50.1, C50.2, C50.3, C50.4, C50.5, C50.6 and C50.8.
ICD 10 Breast Cancer With Mets To Bone
A patient with primary breast cancer and is now seen for metastatic bone cancer will have a code for the secondary bone cancer (C79.51) sequenced before a code for the primary breast cancer (C50.xx).
ICD 10 Code For Breast Cancer With Brain Mets
A patient who has primary breast cancer (C50.xx) who is now seen for metastatic brain cancer will have a code for the secondary brain cancer (C79.31) sequenced before a code for the primary breast cancer (C50.xx).
ICD 10 Code For Triple Negative Breast Cancer
ICD 10 codes include C50.1, C50.3, C50.9, C50.6, C50.4, C50.2, C50.0, C50.8 and C50.5.
Secondary Breast Cancer ICD 10
Secondary breast cancer ICD 10 code is C79.81.
Breast Cancer Metastasis To Lung ICD 10
A patient who has primary breast cancer (C50.xx) who is now seen for metastatic lung cancer will have a code for the secondary lung cancer (C78.00) sequenced before a code for the primary breast cancer (C50.xx).
Breast Cancer ICD 11
The ICD 11 code for Malignant neoplasms of the breast is (2C60-2C6Z).
The category refers to primary malignant neoplasms of parenchyma, connective, and soft tissue of the breast, including nipple and areola.
It can be found in chapter 02 Neoplasms, under the block Malignant neoplasms, except primary neoplasms of the lymphoid, hematopoietic, central nervous system, or related tissues coded as (2B50-2E2Z).
Under the category, Malignant neoplasms stated or presumed to be primary, of specified sites, except lymphoid, hematopoietic, central nervous system, or related tissues coded as (2B50-2D3Z).
Sections/codes include:
Carcinoma of breast, specialized type (2C60).
Invasive carcinoma of the breast (2C61).
Inflammatory carcinoma of the breast (2C62).
Malignant phyllodes tumor of the breast (2C63).
Solid papillary carcinoma of the breast with evidence of invasion (2C64).
Hereditary breast and ovarian cancer syndrome (2C65).
Other specified malignant neoplasms of the breast (2C6Y).
Malignant neoplasms of breast, unspecified (2C6Z).
Excluded in this category are:
- Malignant neoplasm of skin of the breast (2C30-2C3Z)
- Malignant mesenchymal neoplasms (2B50-2B5Z).
