ICD-10 C50.022
Billable / Specific HCC v28: 12Malignant neoplasm of nipple and areola, left male breast
About ICD-10-CM C50.022
ICD-10-CM code C50.022 represents Malignant neoplasm of nipple and areola, left male breast. This is a billable/specific code in the chapter (block C50). The 2026 edition of ICD-10-CM C50.022 became effective on October 1, 2025.
Coding Tips for C50.022
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
C50.022 is a CMS-HCC v28 risk-adjustment code (category 12). To count for the patient Risk Adjustment Factor (RAF), document the diagnosis with MEAT language each calendar year: Monitored, Evaluated, Assessed, Treated. A diagnosis on the problem list alone does not satisfy CMS RADV audit standards. Include the diagnosis in the assessment with current status and current treatment plan.
Medicare Advantage HCC Impact
Capture this diagnosis annually for accurate risk adjustment. Missed HCC captures are the #1 revenue leak in Medicare Advantage risk programs.
Medicare LCD Coverage for C50.022
Local Coverage Determinations (LCDs) from CMS MACs that list C50.022 as a covered diagnosis.
Showing top 10 of 1,939 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing C50.022.
5 Medicare
CPT Codes Commonly Billed with C50.022
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 11922 CMS LCD: Billing and Coding: Cosmetic and Reconstructive Surgery CMS LCD
- 19369 CMS LCD: Billing and Coding: Cosmetic and Reconstructive Surgery CMS LCD
- 11951 CMS LCD: Billing and Coding: Cosmetic and Reconstructive Surgery CMS LCD
- 19357 CMS LCD: Billing and Coding: Cosmetic and Reconstructive Surgery CMS LCD
- 19396 CMS LCD: Billing and Coding: Cosmetic and Reconstructive Surgery CMS LCD
- 11921 CMS LCD: Billing and Coding: Cosmetic and Reconstructive Surgery CMS LCD
- 15847 CMS LCD: Billing and Coding: Cosmetic and Reconstructive Surgery CMS LCD
- 15824 CMS LCD: Billing and Coding: Cosmetic and Reconstructive Surgery CMS LCD
- 30420 CMS LCD: Billing and Coding: Cosmetic and Reconstructive Surgery CMS LCD
- 21235 CMS LCD: Billing and Coding: Cosmetic and Reconstructive Surgery CMS LCD
Convert C50.022 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| C50.022 | 1750 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To C50.022
Other codes in section C50 (Malignant neoplasms of breast).
ICD-10 C50.022, Billing FAQ
Is ICD-10 code C50.022 billable? +
Yes, C50.022 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
Does C50.022 affect Medicare Advantage HCC risk adjustment? +
Yes. C50.022 maps to CMS-HCC v28 category 12. Capture this diagnosis annually for accurate Medicare Advantage risk score.
What CPT codes are commonly billed with C50.022? +
Procedures frequently paired with C50.022 include: 11922, 19369, 11951, 19357, 19396.
What ICD-9 codes does C50.022 map to? +
Per CMS GEMs, C50.022 maps to ICD-9 codes: 1750. Useful for legacy data review and historical claim analysis.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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