C50.021 — Malignant neoplasm of nipple and areola, right male breast

Risk adjustment

C50.021 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

C50.021 is named in 130 Medicare coverage policies — 130 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
• A52450Billing and Coding: Paclitaxel (e.g., Taxol®/Abraxane ™)
• A52450Billing and Coding: Paclitaxel (e.g., Taxol®/Abraxane ™)
• A52453Billing and Coding: Luteinizing Hormone-Releasing Hormone (LHRH) Analogs