C50.411: Malignant neoplasm of upper-outer quadrant of right female breast
C50.411 is a billable, specific ICD-10-CM code for malignant neoplasm of upper-outer quadrant of right female breast. It is valid for submission on a claim.
Check C50.411 with the rest of the claim: free scrubberOther codes that can never be billed with C50.411
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
C50.411 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. Look up the whole chart to see which of its HCCs the hierarchy would zero.
Medicare coverage
C50.411 is named in 114 Medicare coverage policies: 114 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A52370Billing and Coding: Bevacizumab and biosimilars
- A52399Billing and Coding: Denosumab (Prolia®, Xgeva®, Jubbonti®) and biosimilars
- A52450Billing and Coding: Paclitaxel (e.g., Taxol®/Abraxane ™)
- A52453Billing and Coding: Luteinizing Hormone-Releasing Hormone (LHRH) Analogs
Code history
Unchanged in every release from FY2024 to FY2027.