C61 — Malignant neoplasm of prostate
C61 is a billable, specific ICD-10-CM code for malignant neoplasm of prostate. It is valid for submission on a claim.
Excludes1 — never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
- malignant neoplasm of seminal vesicle (C63.7)
Use additional code
Add a secondary code to capture the detail described below.
Risk adjustment
C61 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- 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
C61 is named in 133 Medicare coverage policies — 133 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®) and biosimilars
- A52450Billing and Coding: Paclitaxel (e.g., Taxol®/Abraxane ™)
- A52450Billing and Coding: Paclitaxel (e.g., Taxol®/Abraxane ™)
How C61 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to C61.
- Adenocarcinoma›duct›unspecified site›male
- Carcinoma›endometrioid›unspecified site›male
- Cystadenocarcinoma›endometrioid›unspecified site›male
Code history
C61 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.
Questions about C61
- Is C61 a billable ICD-10-CM code?
- Yes. C61 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does C61 sit in the tabular list?
- Neoplasms (C00-D49), in the block Malignant neoplasms of male genital organs (C60-C63).
- What cannot be coded together with C61?
- C61 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter.