C50.419 — Malignant neoplasm of upper-outer quadrant of unspecified female breast
C50.419 is a billable, specific ICD-10-CM code for malignant neoplasm of upper-outer quadrant of unspecified female breast. It is valid for submission on a claim.
Excludes1 inherited from the categories above C50.419
These are not written on C50.419, but they bind it: a note on a category applies to every code beneath it. Billing C50.419 with anything listed here is a denial.
Other codes that can never be billed with C50.419
These codes carry an Excludes1 note pointing at C50.419. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading C50.419 alone.
Risk adjustment
C50.419 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
C50.419 is named in 73 Medicare coverage policies — 73 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 ™)
- A52478External Breast Prostheses - Policy Article
Code history
C50.419 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.
Related codes at this level
Codes that share C50.41. If C50.419 is not quite right, the correct code is usually one of these.
Questions about C50.419
- Is C50.419 a billable ICD-10-CM code?
- Yes. C50.419 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does C50.419 sit in the tabular list?
- Neoplasms (C00-D49), in the block Malignant neoplasms of breast (C50).
- What cannot be coded together with C50.419?
- C50.419 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 C50.419 (C50) and apply to it just the same.