Is C68.0 a billable ICD-10-CM code?

Yes. C68.0 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does C68.0 sit in the tabular list?

Neoplasms (C00-D49), in the block Malignant neoplasms of urinary tract (C64-C68).

What cannot be coded together with C68.0?

C68.0 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 C68.0 (C68) and apply to it just the same.

C68.0

C68.0 — Malignant neoplasm of urethra

Billable / specific codeICD-10-CM

C68.0 is a billable, specific ICD-10-CM code for malignant neoplasm of urethra. 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 urethral orifice of bladder (C67.5)

Excludes1 inherited from the categories above C68.0

These are not written on C68.0, but they bind it: a note on a category applies to every code beneath it. Billing C68.0 with anything listed here is a denial.

Written on C68 — Malignant neoplasm of other and unspecified urinary organs

malignant neoplasm of female genitourinary tract NOS (C57.9)
malignant neoplasm of male genitourinary tract NOS (C63.9)

Risk adjustment

C68.0 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

C68.0 is named in 68 Medicare coverage policies — 68 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
A52480Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) - Policy Article

Code history

C68.0 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 C68. If C68.0 is not quite right, the correct code is usually one of these.

Questions about C68.0

Is C68.0 a billable ICD-10-CM code?: Yes. C68.0 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does C68.0 sit in the tabular list?: Neoplasms (C00-D49), in the block Malignant neoplasms of urinary tract (C64-C68).
What cannot be coded together with C68.0?: C68.0 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 C68.0 (C68) and apply to it just the same.