ICD-10-CM Code C61

Malignant neoplasm of prostate

Version 2020 Billable Code Diagnoses For Males Only Neoplasm Malignant Primary

Valid for Submission

C61 is a billable code used to specify a medical diagnosis of malignant neoplasm of prostate. The code is valid for the year 2020 for the submission of HIPAA-covered transactions. The ICD-10-CM code C61 might also be used to specify conditions or terms like adenocarcinoma of prostate, carcinoma of prostate, endometrioid carcinoma of prostate, extraprostatic extension of tumor present, extraprostatic extension of tumor present, focal, extraprostatic extension of tumor present, multifocal, etc

The code C61 is applicable to male patients only. It is clinically and virtually impossible to use this code on a non-male patient.

The following anatomical sites found in the Table of Neoplasms apply to this code given the correct histological behavior: prostate (gland) .

ICD-10:C61
Short Description:Malignant neoplasm of prostate
Long Description:Malignant neoplasm of prostate

Tabular List of Diseases and Injuries

The Tabular List of Diseases and Injuries is a list of ICD-10 codes, organized "head to toe" into chapters and sections with guidance for inclusions, exclusions, descriptions and more. The following references are applicable to the code C61:

Use Additional Code

Use Additional Code
The “use additional code” indicates that a secondary code could be used to further specify the patient’s condition. This note is not mandatory and is only used if enough information is available to assign an additional code.
  • code to identify:
  • hormone sensitivity status Z19.1 Z19.2
  • rising PSA following treatment for malignant neoplasm of prostate R97.21

Type 1 Excludes

Type 1 Excludes
A type 1 excludes note is a pure excludes note. It means "NOT CODED HERE!" An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
  • malignant neoplasm of seminal vesicle C63.7

Index to Diseases and Injuries

The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10 code(s). The following references for the code C61 are found in the index:


Code Edits

The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10 Code Edits are applicable to this code:

  • Diagnoses for males only - Medicare Code Editor detects inconsistencies between a patient’s sex and any diagnosis on the patient’s record, this code applies to MALES only .

Synonyms

The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:

  • Adenocarcinoma of prostate
  • Carcinoma of prostate
  • Endometrioid carcinoma of prostate
  • Extraprostatic extension of tumor present
  • Extraprostatic extension of tumor present, focal
  • Extraprostatic extension of tumor present, multifocal
  • Extraprostatic extension of tumor present, non-focal
  • Extraprostatic extension of tumor present, unifocal
  • Familial prostate cancer
  • Hormone refractory prostate cancer
  • Hormone sensitive prostate cancer
  • Local recurrence of malignant tumor of prostate
  • Malignant tumor involving an organ by direct extension from prostate
  • Malignant tumor involving an organ by separate metastasis from prostate
  • Malignant tumor involving bladder by direct extension from prostate
  • Malignant tumor involving bladder by separate metastasis from prostate
  • Malignant tumor involving rectum by direct extension from prostate
  • Malignant tumor involving rectum by separate metastasis from prostate
  • Malignant tumor involving seminal vesicle by direct extension from prostate
  • Malignant tumor involving seminal vesicle by separate metastasis from prostate
  • Malignant tumor involving urethra by direct extension from prostate
  • Malignant tumor involving urethra by separate metastasis from prostate
  • Malignant tumor involving vasa deferentia by direct extension from prostate
  • Malignant tumor involving vasa deferentia by separate metastasis from prostate
  • Malignant tumor of prostate
  • Malignant tumor of seminal vesicle
  • Malignant tumor of seminal vesicle
  • Malignant tumor of spermatic cord
  • Metastasis from malignant tumor of prostate
  • Metastatic castration-resistant prostate cancer
  • Neoplasm of prostate distant metastasis staging category M0: No distant metastasis
  • Neoplasm of prostate distant metastasis staging category M1: Distant metastasis
  • Neoplasm of prostate distant metastasis staging category M1a: Metastasis to nonregional lymph node
  • Neoplasm of prostate distant metastasis staging category M1b: Metastasis to bone
  • Neoplasm of prostate distant metastasis staging category M1c: Distant metastasis with or without metastasis to bone
  • Neoplasm of prostate primary tumor staging category pT3a: Extraprostatic extension or microscopic invasion of bladder neck
  • Neoplasm of prostate primary tumor staging category pT4: Invasion of rectum, levator muscles, and/or pelvic wall
  • Neoplasm of prostate primary tumor staging category T1c: Tumor identified by needle biopsy
  • Neoplasm of prostate primary tumor staging category T2a: Involves one-half of one lobe or less
  • Neoplasm of prostate primary tumor staging category T2b: Tumor involves more than one-half of one lobe but not both lobes
  • Neoplasm of prostate primary tumor staging category T2c: Tumor involves both lobes
  • Neoplasm of prostate primary tumor staging category TX: Primary tumor cannot be assessed
  • Neoplasm of prostate regional lymph node staging category N0: No regional lymph node metastasis
  • Neoplasm of prostate regional lymph node staging category NX: regional lymph nodes not assessed
  • Neoplasm of prostate regional lymph node staging category pN1: Metastasis in regional node
  • Neoplasm of vas deferens
  • Non-metastatic prostate cancer
  • Obstructive nephropathy due to malignancy
  • Obstructive nephropathy due to prostate cancer
  • pM1a: Distant metastasis to non-regional lymph node
  • pM1b: Distant metastasis to bone
  • pM1c category
  • pM1c: Distant metastasis site other than bone or non-regional lymph node
  • Primary malignant neoplasm of prostate
  • Prostate cancer metastatic to bone
  • Prostate cancer metastatic to eye
  • pT2: Organ confined
  • pT2a: Unilateral, one-half of one lobe or less
  • pT2b: Unilateral, involving more than one-half of lobe but not both lobes
  • pT2c category
  • pT2c: Bilateral disease
  • pT3: Extraprostatic extension
  • pT3a: Extraprostatic extension
  • pT3b: Seminal vesicle invasion
  • pT4: Invasion of bladder AND/OR rectum
  • Recurrent malignant neoplasm of prostate
  • Secondary malignant neoplasm of rectum
  • Secondary malignant neoplasm of seminal vesicle
  • Secondary malignant neoplasm of spermatic cord
  • Secondary malignant neoplasm of urethra
  • Secondary malignant neoplasm of vas deferens
  • Small cell carcinoma of prostate
  • Squamous cell carcinoma of prostate
  • T1: Clinically inapparent prostate tumor not palpable or visible by imaging
  • T1a: Prostate tumor incidental histologic finding in 5% or less of tissue resected
  • T1b: Prostate tumor incidental histologic finding in > 5% of tissue resected
  • T1c: Tumor identified by needle biopsy because of elevated PSA: PROSTATE: Biopsy/TURP: PROSTATE: Resection
  • T2: Tumor confined within the prostate
  • T2a: Prostate tumor involves one lobe
  • T3: Prostate tumor extends through the prostatic capsule
  • T3a: Prostate tumor with extracapsular extension
  • T3b: Prostate tumor invades the seminal vesicle
  • Tumor invasion of perineural tissue absent
  • Tumor invasion of perineural tissue present
  • Tumor invasion of periprostatic fat absent
  • Tumor of seminal vesicle
  • Tumor of seminal vesicle

Diagnostic Related Groups

The ICD-10 code C61 is grouped in the following groups for version MS-DRG V37.0 What are Diagnostic Related Groups?
The Diagnostic Related Groups (DRGs) are a patient classification scheme which provides a means of relating the type of patients a hospital treats. The DRGs divides all possible principal diagnoses into mutually exclusive principal diagnosis areas referred to as Major Diagnostic Categories (MDC).
applicable from 10/01/2020 through 09/30/2020.

  • 715 - OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITH CC/MCC
  • 716 - OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITHOUT CC/MCC

Convert C61 to ICD-9

  • 185 - Malign neopl prostate

Code Classification

  • Neoplasms (C00–D48)
    • Malignant neoplasms of male genital organs (C60-C63)
      • Malignant neoplasm of prostate (C61)

Code History

  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016
    (First year ICD-10-CM implemented into the HIPAA code set)
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020

Table of Neoplasms

The code C61 is included in the table of neoplasms by anatomical site. For each site there are six possible code numbers according to whether the neoplasm in question is malignant, benign, in situ, of uncertain behavior, or of unspecified nature. The description of the neoplasm will often indicate which of the six columns is appropriate.

Where such descriptors are not present, the remainder of the Index should be consulted where guidance is given to the appropriate column for each morphological (histological) variety listed. However, the guidance in the Index can be overridden if one of the descriptors mentioned above is present.

Neoplasm, neoplastic Malignant
Primary
Malignant
Secondary
CaInSitu Benign Uncertain
Behavior
Unspecified
Behavior
»prostate (gland)
C61C79.82D07.5D29.1D40.0D49.59

Information for Patients


Prostate Cancer

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, and being African-American.

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

To diagnose prostate cancer, you doctor may do a digital rectal exam to feel the prostate for lumps or anything unusual. You may also get a blood test for prostate-specific antigen (PSA). These tests are also used in prostate cancer screening, which looks for cancer before you have symptoms. If your results are abnormal, you may need more tests, such as an ultrasound, MRI, or biopsy.

Treatment often depends on the stage of the cancer. How fast the cancer grows and how different it is from surrounding tissue helps determine the stage. Men with prostate cancer have many treatment options. The treatment that's best for one man may not be best for another. The options include watchful waiting, surgery, radiation therapy, hormone therapy, and chemotherapy. You may have a combination of treatments.

NIH: National Cancer Institute


[Learn More]

Prostate cancer Prostate cancer is a common disease that affects men, usually in middle age or later. In this disorder, certain cells in the prostate become abnormal and multiply without control or order to form a tumor. The prostate is a gland that surrounds the male urethra and helps produce semen, the fluid that carries sperm.Early prostate cancer usually does not cause pain, and most affected men exhibit no noticeable symptoms. Men are often diagnosed as the result of health screenings, such as a blood test for a substance called prostate specific antigen (PSA) or a medical procedure called a digital rectal exam. As the tumor grows larger, signs and symptoms can include difficulty starting or stopping the flow of urine, a feeling of not being able to empty the bladder completely, blood in the urine or semen, or pain with ejaculation. However, these changes can also occur with many other genitourinary conditions. Having one or more of these symptoms does not necessarily mean that a man has prostate cancer.The severity and outcome of prostate cancer varies widely. Early-stage prostate cancer can usually be treated successfully, and some older men have prostate tumors that grow so slowly that they may never cause health problems during their lifetime, even without treatment. In other men, however, the cancer is much more aggressive; in these cases, prostate cancer can be life-threatening.Some cancerous tumors can invade surrounding tissue and spread to other parts of the body. Tumors that begin at one site and then spread to other areas of the body are called metastatic cancers. The signs and symptoms of metastatic cancer depend on where the disease has spread. If prostate cancer spreads, cancerous cells most often appear in the lymph nodes, bones, lungs, liver, or brain. Bone metastases of prostate cancer most often cause pain in the lower back, pelvis, or hips.A small percentage of all prostate cancers cluster in families. These hereditary cancers are associated with inherited gene mutations. Hereditary prostate cancers tend to develop earlier in life than non-inherited (sporadic) cases.
[Learn More]