Regarded as a common cancer type, bladder cancer refers to the abnormal growth of bladder cells. The bladder is a hollow, muscular organ in the lower abdomen area that stores urine. It is estimated that men have a higher risk of getting bladder cancer than women. Often, the condition begins in the urothelial cells – that line the inside part of the bladder. In addition, urothelial cells are found in the kidneys and the tubes (ureters) that connect the kidneys to the bladder. Blood in the urine (which is usually painless) is one of the most common symptoms associated with the condition. In most cases, bladder cancers are diagnosed at an early stage, when the condition is highly treatable. People suffering from this type of cancer need to correctly undergo follow-up tests even after successful treatment. For correct clinical documentation of this condition, physicians can utilize the outsourced services of professional medical billing companies.

Causes and Types of Bladder Cancer

The exact cause of bladder cancer is unknown. The condition begins when cells in the bladder develop changes (mutations) in their DNA. The abnormal cells in the bladder grow and multiply quickly and uncontrollably and invade other tissues. It forms a tumor that can invade and destroy normal body tissue. Over time, these abnormal cells can break away and spread (metastasize) through the body. There are different types of cells in the bladder that can become cancerous. The type of bladder cells where cancer begins determines the type of bladder cancer. The three different types of cancer that occur in the bladder include –

  • Transitional Cell Carcinoma – This is the most common type of bladder cancer in the United States. Also called urothelial carcinoma, the condition occurs in the transitional cells in the inner layer of the bladder that change shape without becoming damaged when the tissue is stretched.
  • Squamous Cell Carcinoma – A very rare form of cancer, squamous cell carcinoma occurs due to a chronic irritation of the bladder such as an infection or irritation in the bladder.
  • Adenocarcinoma – This type of cancer begins when glandular cells (that make up the mucus-secreting glands in the body) form in the bladder after long-term bladder irritation and inflammation.

Most cases of bladder cancer tend to be caused by exposure to harmful substances, which causes abnormal changes in the bladder cells over many years. Tobacco smoke is a common cause and it’s estimated that more than 1 in 3 cases of bladder cancer are caused by smoking. Other associated risk factors include – increasing age, personal or family history of cancer, being a male patient, low-fluid consumption, eating high-fat diet, chronic bladder inflammation and previous cancer treatments.

Signs and Symptoms

There are certain symptoms associated with bladder cancer. In most cases, blood in the urine (without any specific pain while urinating) is one of the most common symptoms. Other related symptoms include –

  • Frequent and urgent urination
  • Urinary incontinence
  • Painful urination
  • Pain in the abdominal area
  • Chronic pain in the lower back area

If the cancer in the bladder cells reaches an advanced stage and begins to spread, certain symptoms like – unintentional weight loss, pelvic pain, bone pain and swelling of the legs tend to appear.

How to Diagnose and Treat Bladder Cancer?

People with symptoms of bladder cancer like – blood in the urine- need to immediately consult a general physician or an urologist. As part of the initial diagnosis, physicians may perform a detailed physical examination of the rectum and vagina, as the condition may sometimes causes a noticeable lump that presses against them. They may also enquire about the symptoms, family history and whether the patients have been exposed to any possible causes of bladder cancer, like smoking. If the physician suspects bladder cancer, patients will be referred to a hospital for further detailed tests and procedures. Additional tests performed include – cystoscopy (using a scope to examine the inside of your bladder), urine cytology (analyzing urine samples) and biopsy (removing a sample of tissue for testing). In addition, imaging tests, such as computerized tomography (CT) urogram or retrograde pyelogram, may also be performed to examine the structures of the urinary tract. Once bladder cancer is confirmed, physicians may recommend additional tests like – CT scan, Magnetic resonance imaging (MRI), Positron emission tomography (PET), Bone scan and Chest X-ray to determine whether the cancer has spread to the lymph nodes or to other areas of the body.

Physicians rate bladder cancer with a staging system that goes from stages 0 to 4 to identify how far the cancer has spread.

  • Stage 0 – where the cancer hasn’t spread past the lining of the bladder.
  • Stage 1 – where the cancer has spread past the lining of the bladder, but it hasn’t reached the layer of muscle in the bladder.
  • Stage 2 – where the tumor has spread to the layer of muscle in the bladder.
  • Stage 3 – where the tumor has spread into the tissues that surround the bladder.
  • Stage 4 – where the tumor has spread past the bladder to the neighboring areas of the body.

Treatment modalities for bladder cancer are based on the type and stage of the cancer, related patient symptoms, and the overall health of the patient. Top treatment modalities include – surgery to remove the cancer cells, chemotherapy in the bladder (intravesical chemotherapy), chemotherapy for the whole body (systemic chemotherapy), radiation therapy to destroy cancer cells, immunotherapy to trigger the body’s immune system to fight cancer cells (either in the bladder or throughout the body), and targeted therapy to treat advanced cancer when other treatments don’t yield the expected results. Surgical options to remove the cancer cells include – Transurethral resection of bladder tumor (TURBT), Cystectomy, Neo-bladder reconstruction and Continent urinary reservoir. In certain cases, a combination of treatment approaches may be recommended – depending on the severity of the conditions.

ICD-10 Codes for Bladder Cancer

Urology medical billing and coding can be challenging. Urologists or other specialists treating bladder cancer patients must correctly document the screening tests and other treatment procedures they provide using the right medical codes. Outsourced billing services from reputable billing and coding companies can help with timely claim submissions for accurate reimbursement. ICD-10 codes for bladder cancer include –

  • C67 Malignant neoplasm of bladder
  • C67.0 Malignant neoplasm of trigone of bladder
  • C67.1 Malignant neoplasm of dome of bladder
  • C67.2 Malignant neoplasm of lateral wall of bladder
  • C67.3 Malignant neoplasm of anterior wall of bladder
  • C67.4 Malignant neoplasm of posterior wall of bladder
  • C67.5 Malignant neoplasm of bladder neck
  • C67.6 Malignant neoplasm of ureteric orifice
  • C67.7 Malignant neoplasm of urachus
  • C67.8 Malignant neoplasm of overlapping sites of bladder
  • C67.9 Malignant neoplasm of bladder, unspecified

Although there’s no guaranteed way to prevent the occurrence of bladder cancer, several steps like – stopping the habit of smoking, eating a healthy and low-fat diet and reducing exposure to certain harmful chemicals can help reduce the risk of this condition in the long run.

Urology medical billing and coding can be complex and therefore requires adequate knowledge regarding appropriate codes and modifiers. Payer-specific medical billing is essential for correct and on-time reimbursement. With all the complexities involved, the support of a reliable medical billing and coding service provider can be helpful for physicians to report the bladder condition correctly.