What is the ICD-10-CM code for a malignant neoplasm in the upper-outer quadrant of the left breast in a female patient with estrogen-receptor-positive, stage 1B disease?

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ICD-10-CM Code for Malignant Neoplasm of Upper Outer Quadrant of Left Breast, Female, Estrogen Receptor Positive, Stage 1B

The ICD-10-CM code is C50.412 for the malignant neoplasm of the upper outer quadrant of the left breast in a female patient.

Primary Diagnosis Code

  • C50.412 specifically identifies malignant neoplasm of upper outer quadrant of left female breast 1
  • This code captures the anatomic location (upper outer quadrant) and laterality (left breast) required for accurate documentation 1

Additional Required Codes for Complete Documentation

Estrogen Receptor Status

  • Z17.0 should be added to indicate estrogen receptor positive status 1
  • This code is essential for treatment planning and prognosis, as ER-positive tumors respond to endocrine therapy 2, 3
  • ER positivity is defined as 1% or more cells staining positive on immunohistochemistry 2

Stage Classification

  • Stage 1B breast cancer requires documentation of the specific T and N classification 1
  • Stage 1B corresponds to either T0N1mi or T1N1mi (micrometastases in 1-3 axillary lymph nodes) 1
  • Consider adding appropriate TNM staging codes if your documentation system requires granular staging detail 1

Clinical Context for Coding Accuracy

  • The pathology report must document ER status through immunohistochemical evaluation using standardized methodology (Allred or H-score) 1
  • Progesterone receptor (PR) and HER2 status should also be documented with separate codes if positive, as these influence treatment decisions 1
  • Ki67 proliferation index, while not directly coded, helps classify the tumor into molecular subtypes (luminal A vs. luminal B) 1

Common Coding Pitfalls to Avoid

  • Do not use unspecified breast codes (C50.919) when the specific quadrant is documented 1
  • Always include the estrogen receptor status code (Z17.0) as it directly impacts treatment selection and reimbursement for endocrine therapy 1, 2
  • Ensure the stage documented matches the pathologic findings; Stage 1B requires either micrometastases (N1mi) or small primary tumor with limited nodal involvement 1
  • If HER2 status is negative, this does not require a separate code, but if positive, appropriate coding for HER2 status should be included 1

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Estrogen and progesterone receptors in breast cancer.

Future oncology (London, England), 2014

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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