Is C50.4 a billable ICD-10-CM code?

No. C50.4 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does C50.4 sit in the tabular list?

Neoplasms (C00-D49), in the block Malignant neoplasms of breast (C50).

What cannot be coded together with C50.4?

C50.4 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above C50.4 (C50) and apply to it just the same.

C50.4

C50.4 — Malignant neoplasm of upper-outer quadrant of breast

Non-billable headerICD-10-CM

C50.4 is a non-billable header ICD-10-CM code for malignant neoplasm of upper-outer quadrant of breast. It cannot be billed on its own: choose one of the more specific child codes below.

Excludes1 inherited from the categories above C50.4

These are not written on C50.4, but they bind it: a note on a category applies to every code beneath it. Billing C50.4 with anything listed here is a denial.

Written on C50 — Malignant neoplasm of breast

skin of breast (C44.501, C44.511, C44.521, C44.591)

Other codes that can never be billed with C50.4

These codes carry an Excludes1 note pointing at C50.4. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading C50.4 alone.

C49Malignant neoplasm of other connective and soft tissue
C49.3Malignant neoplasm of connective and soft tissue of thorax
D05Carcinoma in situ of breast

Risk adjustment

C50.4 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

Code history

C50.4 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Code to one of these instead C50.4

2 child codes. Green means billable.

Related codes at this level

Codes that share C50. If C50.4 is not quite right, the correct code is usually one of these.

Questions about C50.4

Is C50.4 a billable ICD-10-CM code?: No. C50.4 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does C50.4 sit in the tabular list?: Neoplasms (C00-D49), in the block Malignant neoplasms of breast (C50).
What cannot be coded together with C50.4?: C50.4 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above C50.4 (C50) and apply to it just the same.