Disease of the Breast
When we think about diseases of the breast, most of us think about breast cancer and – even more so – we think about females and breast cancer.
In the current language of ICD-9-CM, reporting breast cancer for females falls under category 174 with the fourth character indicating where on the breast the disease has invaded. For reporting breast cancer in males we are given two choices with ICD-9-CM: 175.0 Malignant neoplasm of male breast; nipple and areola or 175.9 Malignant neoplasm of male breast; other and unspecified. As we move forward into ICD-10-CM the reporting possibilities change. For both the male and female breast cancer patient we need to know if the cancer is in the right breast, left breast, or both. As an example, a female patient with breast cancer of the central portion of her right and left breast would be reported today with 174.1; with ICD-10-CM this is reported with C50.111 Malignant neoplasm of central portion of right female breast and C50.112 Malignant neoplasm of central portion of left female breast. The same specificity is there for breast cancer in males. If your provider is documenting breast cancer of the male breast then check the documentation to make sure you have sufficient information to report the condition completely in ICD-10-CM. Some examples of what you would report for male breast cancer would be: C50.321 Malignant neoplasm of lower-inner quadrant of right male breast and C50.822 Malignant neoplasm of overlapping sites of left male breast. With all codes in the C50 category (Malignant neoplasm of breast) there is an instructional note to also report the estrogen receptor status, also (Z17.0 Estrogen receptor positive status or Z17.1 Estrogen receptor negative status) if known.
Take a good look at your documentation now to be sure location and laterality are documented in order to transition into ICD-10-CM for breast cancer coding, taking into account that it may become necessary to report two codes as shown in the example above.