ICD Code C54.1

ICD code C54.1 is a classification used to identify a malignant neoplasm, or cancerous tumor, located in the endometrium, which is the inner lining of the uterus. This code is utilized by healthcare providers to document and communicate the diagnosis of endometrial cancer for purposes such as treatment planning, billing, and statistical analysis.

1. Abnormal Uterine Bleeding: Persistent or unusual bleeding that is not associated with the menstrual cycle, especially in postmenopausal women, should be evaluated for potential malignancy.

2. Pelvic Pain: Unexplained or chronic pelvic pain that does not resolve with standard treatment may warrant further investigation for underlying malignancies.

3. Unintended Weight Loss: Significant and unexplained weight loss can be a symptom of various cancers, including those affecting the endometrium.

4. Pelvic Mass: The presence of a palpable mass in the pelvic region detected during a physical examination or imaging studies may indicate a neoplastic process.

5. Thickened Endometrium: Imaging studies, such as ultrasound, revealing a thickened endometrial lining can be a sign of endometrial pathology, including malignancy.

6. Postmenopausal Bleeding: Any bleeding occurring after menopause is considered abnormal and should be evaluated for possible endometrial cancer.

7. Family History of Cancer: A family history of endometrial or other related cancers may increase the suspicion of malignancy in symptomatic individuals.

8. Hormonal Imbalances: Conditions leading to prolonged exposure to estrogen without progesterone, such as polycystic ovary syndrome (PCOS) or hormone replacement therapy, may increase the risk of endometrial cancer.

9. Genetic Predisposition: Known genetic syndromes, such as Lynch syndrome, that increase the risk of endometrial cancer should prompt consideration of malignancy in symptomatic patients.

10. Age and Risk Factors: Women over the age of 50 or those with risk factors such as obesity, diabetes, or hypertension should be evaluated more closely when presenting with symptoms suggestive of endometrial pathology.

For the ICD code C54.1, which pertains to a malignant neoplasm of the endometrium, the relevant CPT codes that may be applicable for treatment or procedures include:

1. 58150 - Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s).

2. 58571 - Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s).

3. 58951 - Resection of ovarian, tubal, or primary peritoneal malignancy with omentectomy, total abdominal hysterectomy with bilateral salpingo-oophorectomy and pelvic lymphadenectomy and limited para-aortic lymphadenectomy.

4. 58152 - Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s); with colpo-urethrocystopexy (Marshall-Marchetti-Krantz type, Pereyra type).

5. 58200 - Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s); with enterocele repair.

6. 58548 - Laparoscopy, surgical, with radical hysterectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy), with or without removal of tube(s), with or without removal of ovary(s).

These CPT codes represent a range of surgical procedures that may be performed as part of the treatment plan for a patient diagnosed with a malignant neoplasm of the endometrium. It is important for healthcare providers to select the appropriate CPT code based on the specific procedure performed and the individual patient's treatment plan.

Discover how MD Clarity's RevFind software can enhance your revenue cycle management by accurately reading your contracts and detecting underpayments for CPT codes associated with ICD code C54.1. Ensure you're receiving the full reimbursement you deserve. Schedule a demo today to see RevFind in action and secure your financial health.