C50.411
BillableMalignant neoplasm of upper-outer quadrant of right female breast
HCC Category Mapping
V28HCC 23 — Melanoma and Other Skin Cancers
0.251V24HCC 12 — Breast, Prostate, and Other Cancers and Tumors
0.150ESRDHCC 12 — Breast, Prostate, and Other Cancers and Tumors
0.000RxHCCHCC 22 — Cancer, Other Specified Sites
0.000What This Code Means
Cancer that starts in the upper-outer area of the right breast in a female patient.
Coding Tips
- •Verify the quadrant location is documented as upper-outer and laterality is right breast
- •Upper-outer quadrant is the most common location for breast cancer; ensure accurate documentation
Clinical Significance
Malignant neoplasm of the upper-outer quadrant of right female breast represents invasive breast cancer requiring staging, treatment planning, and ongoing surveillance. Breast cancer is risk-adjusted because it demands significant healthcare resources including surgery, radiation, chemotherapy, hormonal therapy, and long-term monitoring.
Documentation Requirements
- ✓Pathologic confirmation of invasive malignancy (biopsy with histologic type — ductal, lobular, etc.)
- ✓Laterality: right breast
- ✓Gender documented as female to support gender-specific code selection
- ✓Quadrant or subsite location: upper-outer quadrant
- ✓Tumor size (T stage) and grade
- ✓Lymph node status (N stage) — axillary, sentinel node biopsy results
- ✓Estrogen receptor, progesterone receptor, and HER2 status
- ✓Stage grouping (I-IV)
- ✓Current treatment status (active treatment, hormonal therapy, surveillance)
Commonly Confused Codes
C50.412 — Upper-outer quadrant of left female breast; verify lateralityC50.419 — Upper-outer quadrant unspecified female; use only when laterality unknownC50.421 — Same laterality but male breast; verify patient genderC50.211-C50.219 — Upper-inner quadrant; most common confusion — upper-outer is lateral (toward axilla), upper-inner is medial (toward sternum)C50.511-C50.519 — Lower-outer quadrant; same lateral orientation but lower positionC50.811-C50.819 — Overlapping sites; use when tumor spans multiple quadrants