C67.6 — Malignant neoplasm of ureteric orifice
C67.6 is a billable, specific ICD-10-CM code for malignant neoplasm of ureteric orifice. It is valid for submission on a claim.
Other codes that can never be billed with C67.6
These codes carry an Excludes1 note pointing at C67.6. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading C67.6 alone.
- C66Malignant neoplasm of ureter
Risk adjustment
C67.6 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 22 Bladder, Colorectal, and Other Cancers0.363 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
C67.6 is named in 77 Medicare coverage policies — 77 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A52450Billing and Coding: Paclitaxel (e.g., Taxol®/Abraxane ™)
- A52450Billing and Coding: Paclitaxel (e.g., Taxol®/Abraxane ™)
- A52479Oral Anticancer Drugs - Policy Article
- A52479Oral Anticancer Drugs - Policy Article
Related codes at this level
Codes that share C67. If C67.6 is not quite right, the correct code is usually one of these.
- C67.0Malignant neoplasm of trigone of bladder
- C67.1Malignant neoplasm of dome of bladder
- C67.2Malignant neoplasm of lateral wall of bladder
- C67.3Malignant neoplasm of anterior wall of bladder
- C67.4Malignant neoplasm of posterior wall of bladder
- C67.5Malignant neoplasm of bladder neck
- C67.7Malignant neoplasm of urachus
- C67.8Malignant neoplasm of overlapping sites of bladder
- C67.9Malignant neoplasm of bladder, unspecified
Questions about C67.6
- Is C67.6 a billable ICD-10-CM code?
- Yes. C67.6 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does C67.6 sit in the tabular list?
- Neoplasms (C00-D49), in the block Malignant neoplasms of urinary tract (C64-C68).