C50.011
C50.011 — Malignant neoplasm of nipple and areola, right female breast
Billable / specific codeICD-10-CMright
C50.011 is a billable, specific ICD-10-CM code for malignant neoplasm of nipple and areola, right female breast. It is valid for submission on a claim.
Risk adjustment
C50.011 risk-adjusts. Under the CMS-HCC V28 model it maps to these categories:
- HCC 22 Bladder, Colorectal, and Other Cancers0.363 RAF
- HCC 23 Prostate, Breast, and Other Cancers and Tumors0.186 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.
Medicare coverage
C50.011 is named in 147 Medicare coverage policies — 147 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A52370Billing and Coding: Bevacizumab and biosimilars
- A52399Billing and Coding: Denosumab (Prolia®, Xgeva®, Jubbonti®, Wyost®, Ospomyv™,Xbryk™,Bomyntra®, Conexxence®, Stoboclo®, Osenvelt®,Bildyos®, Bilprevda®)
- A52450Billing and Coding: Paclitaxel (e.g., Taxol®/Abraxane ™)
- A52450Billing and Coding: Paclitaxel (e.g., Taxol®/Abraxane ™)
Related codes at this level
Codes that share C50.01. If C50.011 is not quite right, the correct code is usually one of these.
Questions about C50.011
- Is C50.011 a billable ICD-10-CM code?
- Yes. C50.011 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does C50.011 sit in the tabular list?
- Neoplasms (C00-D49), in the block Malignant neoplasms of breast (C50).