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 an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

C61

C61 — Malignant neoplasm of prostate

Billable / specific codeICD-10-CM

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.

code, if applicable, to identify:
hormone sensitivity status (Z19.1-Z19.2)
rising PSA following treatment for malignant neoplasm of prostate (R97.21)

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 124 Medicare coverage policies — 124 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A52399Billing and Coding: Denosumab (Prolia®, Xgeva®, Jubbonti®, Wyost®, Ospomyv™,Xbryk™,Bomyntra®, Conexxence®, Stoboclo®, Osenvelt®,Bildyos®, Bilprevda®)
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

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

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 an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.