ICD-10-CM Code C61 – Malignant neoplasm of prostate

Code: C61 Type: ICD-10-CM (Diagnosis) Status: Active Effective: FY2016-2026 Gender: Male only

What does ICD-10-CM code C61 mean?

C61 represents Malignant neoplasm of prostate. This code is used when a patient has been diagnosed with prostate cancer. It is a single code without subcategories since the prostate is a single unpaired organ without laterality. Coders frequently reference this code as ca prostate icd 10 or ca prostate.

Prostate cancer is the most common cancer in men and the second leading cause of cancer death in American men. Diagnosis often involves PSA testing, digital rectal exam, and transrectal ultrasound-guided biopsy. The Gleason score and TNM staging system are used for grading and staging. Treatment options range from active surveillance to surgery, radiation, and hormonal therapy.

Code category and hierarchy

  • Chapter: 2 – Neoplasms (C00-D49)
  • Category: C61 – Malignant neoplasm of prostate
  • Code: C61 – Malignant neoplasm of prostate

Guideline notes and coding considerations

Important Guideline Note

Assign C61 only when documentation clearly supports this diagnosis. Review the excludes notes and ensure no conflicts with other assigned codes.

  • Excludes1: malignant neoplasm of seminal vesicle ( C63.7 )
  • Use Additional Code: code, if applicable, to identify:; hormone sensitivity status ( Z19.1 - Z19.2 ); rising PSA following treatment for malignant neoplasm of prostate ( R97.21 )

Learn the underlying rules in the Neoplasm Coding Guidelines, Risk Adjustment Documentation.

Documentation tips (what coders should confirm)

  • C61 is a male-only diagnosis code — do not assign to female patients
  • Document Gleason score and PSA levels for clinical completeness
  • Specify if metastatic and code metastatic sites (C79.51 for bone, C78.7 for liver)
  • Note treatment status: hormone therapy (Z79.818), history of radiation (Z92.3)
  • Use additional code for tobacco use/dependence if applicable

When NOT to use C61

Do not assign C61 when the clinical scenario involves: malignant neoplasm of seminal vesicle ( C63.7 ). Review excludes notes and assign the most specific code supported by documentation.

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Risk adjustment and HCC mapping

HCC Impact

C61 (Malignant neoplasm of prostate) maps to the following HCC categories: CMS-HCC V24: HCC 12, CMS-HCC V28: HCC 23, RxHCC V08: HCC 22, ESRD V24: HCC 12. Proper documentation using MEAT criteria (Monitor, Evaluate, Assess/Address, Treat) is required for each encounter to support risk-adjusted diagnoses.

Learn more about risk adjustment documentation in our Risk Adjustment & MEAT Documentation Guide.

Related ICD-10 codes

D07.5

Carcinoma in situ of prostate

N40.0

Benign prostatic hyperplasia without LUTS

Z85.46

Personal history of malignant neoplasm of prostate

C79.51

Secondary malignant neoplasm of bone

Frequently Asked Questions

The ICD-10-CM code for ca prostate is C61, which represents malignant neoplasm of prostate. This code is also commonly referenced as ca prostate. Verify this code using the ICD Code Auditor to ensure guideline compliance.

Yes. C61 is a male-only diagnosis code. Assigning it to a female patient would trigger a validation error in claim processing.

While ICD-10-CM does not have stage-specific codes for prostate cancer, documentation of Gleason score, TNM stage, and PSA levels supports medical necessity and helps with risk adjustment. Metastatic sites require separate codes.

Sources

Reviewed by: Certified ICD-10 Coding & Risk Adjustment Specialist
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