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)
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 60 Medicare coverage policies — 60 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
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 an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.