Breast Cancer ICD 10 Code

Refresher: What are ICD-10 codes?

The ICD-10 stands for the 10th revision of the International Classification of Diseases. It was endorsed by the WHO to allow more consistency in the presentation and classification of mortality statistics.

All reported conditions are assigned specific medical codes with the aid of a classification structure as published by the WHO [¹]. The coding rules are revised periodically to improve the usefulness of mortality statistics, with the 10th revision being the most recent revision.

There are over 68,000 codes in the latest revision compared to only 13,000 in ICD-9, which allows for more accurate diagnostics and care outcomes for patients.

More specifically, healthcare organizations in the US utilize ICD-10-CM (International Classification of Diseases, Tenth Revision, Clinical Modification). The system is based on the ICD published by the WHO and assists healthcare professionals with the storage and retrieval of diagnostic information for different types of cancers. CM, which stands for Clinical Modification, provides a more robust understanding of a patient’s condition.

There is no difference between ICD-10 and ICD-10-CM codes because they refer to the same set of diagnostic codes used in healthcare institutions throughout the US. That said, ICD-10 PCS is an entirely different code set used for hospital inpatient settings and designed to be more accurate and specific for inpatient coding.

A major disadvantage of ICD-10 codes is that it can be possible for patients to be improperly coded and misbilled if the doctor fails to note all aspects of the patient’s visit.

ICD-10 codes are also used for the classification of various primary tumors (“malignant neoplasms”) and secondary or metastasized tumors (“secondary malignant neoplasms”). These will be discussed below.

What is the ICD 10 code for Breast Cancer?

For primary Breast Cancer tumors, the general ICD-10 code is C50 (malignant neoplasm of the breast), whereas for secondary or metastatic tumors, the ICD-10 code is C79.81 (secondary malignant neoplasm of the breast).

Primary Breast Cancer ICD 10 code: C50

Primary Breast Cancer ICD code C50 lookup

Below is a table of the ICD 10 Breast Cancer codes for primary Breast Cancer cancers, which are classified under C50, “malignant neoplasm of the breast.”[²]

C50: Malignant neoplasm of Breast

Types of Breast Cancer coded under C50

The ICD 10 code C50 does not specify the subtype of Breast Cancer. A C50 code can be used for primary Breast Cancers of various types:

• invasive ductal carcinoma
• invasive lobular carcinoma
• Inflammatory breast cancer
• ductal carcinoma in situ
• metastatic breast cancer
• Triple-negative breast cancer

In other words, breast cancer ICD 10, metastatic breast cancer ICD 10, and inflammatory breast cancer ICD 10 codes could all be C50.00 if they are determined to be primary malignant neoplasia of the breast. As a concrete example, a patient diagnosed with Stage 1 breast cancer, with a single tumor found in the nipple and areola, would be coded with C50.01.

Breast Cancer cancers excluded from ICD-10 C50

• Skin cancer of the left breast
• Skin cancer of the right breast
• Skin cancer of both breasts

Unspecified malignant neoplasm of the skin of the breast is diagnosed under C44.501 [³].

Secondary and metastatic Breast Cancer ICD 10 code: C79.81

Secondary or metastatic Breast Cancer ICD-10 code C79.81 lookup

The ICD 10 Breast Cancer codes for secondary Breast Cancer cancers, or Breast Cancer cancers that have metastasized from other origins are C79.81, “Secondary malignant neoplasm of the breast.”[⁴]

Conclusion

The ICD-10 code for breast cancer depends on whether the cancer is primary or secondary neoplasm and its specific location in the breast. Primary breast cancer falls under ICD-10 C50, whereas secondary cancers are coded under C79.81. The ICD-10 code may not specify the exact type of breast cancer, requiring a more specific understanding of the tumor’s pathophysiology and origin as well as the patient’s pre-existing and coexisting conditions to accurately code the cancers.