C64-C68 — Malignant neoplasms of urinary tract
ICD-10-CM codes C64-C68 cover malignant neoplasms of urinary tract, within neoplasms. The block holds 28 codes across 5 categories, of which 23 are billable and 5 are header codes that cannot be submitted on a claim.
Risk adjustment in C64-C68
0 codes in this block map to a CMS-HCC, which means the diagnosis carries a risk-adjustment payment when it is documented and coded. Under-coding here is money left on the table; over-coding here is what audits are for.
- HCC 22 Bladder, Colorectal, and Other Cancers
What else to watch in C64-C68
- 6 codes are laterality-specific. They come in left and right pairs, and the pair is mutually exclusive on a single site: coding both without a bilateral code is a contradiction a scrubber should catch before the payer does.
- 23 codes are named in Medicare coverage policies. An LCD or NCD lists them as supporting medical necessity, or explicitly as not supporting it. Which applies depends on the MAC for your state.