C68.9

C68.9: Malignant neoplasm of urinary organ, unspecified

Billable / specific codeICD-10-CM

C68.9 is a billable, specific ICD-10-CM code for malignant neoplasm of urinary organ, unspecified. It is valid for submission on a claim.

Check C68.9 with the rest of the claim: free scrubber

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Malignant neoplasm of urinary system NOS

Excludes1 inherited from the categories above C68.9

A category’s note binds every code beneath it.

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

C68.9 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. Look up the whole chart to see which of its HCCs the hierarchy would zero.

Medicare coverage

C68.9 is named in 42 Medicare coverage policies: 42 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A52480Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) - Policy Article
A52986Billing and Coding: Biomarkers for Oncology
A53101Billing and Coding: MolDX: bioTheranostics Cancer TYPE ID® Update
A54188Billing and Coding: MolDX: bioTheranostics Cancer TYPE ID®

Code history

Unchanged in every release from FY2024 to FY2027.