Malignant neoplasm of prostate
- 2015
- Billable Thru Sept 30/2015
- Non-Billable On/After Oct 1/2015
- Male Only Dx
- ICD-9-CM 185 is a billable medical code that can be used to indicate a diagnosis on a reimbursement claim, however, 185 should only be used for claims with a date of service on or before September 30, 2015. For claims with a date of service on or after October 1, 2015, use an equivalent ICD-10-CM code (or codes).
Convert to ICD-10-CM: 185 converts directly to:
- 2015/16 ICD-10-CM C61 Malignant neoplasm of prostate
Approximate Synonyms
- Adenocarcinoma of prostate
- Adenocarcinoma, prostate
- CA of prostate
- CA prostate, adenoca
- CA prostate, primary
- Cancer of prostate with metastasis to eye
- Cancer of the prostate
- Cancer of the prostate with metastasis
- Cancer of the prostate, adenocarcinoma
- Cancer of the prostate, primary
- Cancer of, prostate, hormone refractory
- Carcinoma of prostate
- Hormone refractory prostate cancer
- Metastasis from malignant tumor of prostate
- Metastatic prostate cancer
- Primary malignant neoplasm of prostate
- Prostate cancer
- Prostate cancer metastatic to eye
- Prostate cancer, hormone refractory
Clinical Information
- A primary or metastatic malignant tumor involving the prostate gland. The vast majority are carcinomas
- The prostate is the gland below a man's bladder that produces fluid for semen. Prostate cancer is common among older men. It is rare in men younger than 40. Risk factors for developing prostate cancer include being over 65 years of age, family history, being african-american, and some genetic changes.symptoms of prostate cancer may include
- problems passing urine, such as pain, difficulty starting or stopping the stream, or dribbling
- low back pain
- pain with ejaculation
185 Excludes
- seminal vesicles (187.8)
ICD-9-CM Coding Information
- 185 is only applicable to male patients.
On October 1, 2016, new codes were implemented in the ICD-10-CM. This was the first update since the original ICD-10-CM version was published in 2015. Among this update is a change to help identify different manifestations for prostate cancer.
To identify prostate cancer, diagnosis code C61 Malignant neoplasm of prostate was established, as well as “ “use additional code to identify” guidance for hormone sensitivity status and for rising prostate-specific antigen (PSA) following prostate cancer treatment .
The ICD-10-CM manual lists the following:
C61 Malignant neoplasm of prostate
Use additional code to identify
Hormone sensitivity status (Z19.1-Z19.2)
Rising PSA following treatment for malignant neoplasm of prostate (R97.21)
The hormone sensitivity status codes include:
Z19.1 Hormone sensitive malignancy status
Z19.2 Hormone resistant malignancy status
When using diagnosis code C61, you can also add the additional codes for more specific identification. It should not be required to add the codes if they are not relevant. Some clearinghouses are requiring the use of the additional codes before claims are processed but this should not be the case.
The AUA has unlimited expert coding advice through the Coding Hotline which is part of the Practice Management Network. For more information on the Coding hotline and other Coding Products please click here.