Malignant Neoplasm of the Kidney B012

Current RMA Instruments

Changes from previous Instruments

ICD Coding

• ICD-9-CM Codes: 189.0
• ICD-10-AM Codes: C64

Brief description

This SOP covers carcinoma of the body of the kidney, but not carcinoma of the pelvis of the kidney (the collection and drainage part). Almost all cancers of the body of the kidney in adults are adenocarcinomas.

Confirming the diagnosis

The diagnosis requires confirmation by histology, from a biopsy or surgical specimen.

The relevant medical specialist is a urologist.

Additional diagnoses covered by SOP

• Adenocarcinoma of the kidney
• Clear cell carcinoma of the kidney
• Hypernephroma
• Renal cell carcinoma
• Renal medullary carcinoma

Conditions not covered by SOP

• Carcinoid of the kidney^#
• Malignant neoplasm of the renal pelvis and renal calyces*
• Hodgkin's lymphoma* of the kidney
• non-Hodgkin lymphoma* of the kidney
• Soft tissue sarcoma* of the kidney

* Another SOP applies

^# Non-SOP condition

Clinical onset

In many cases the condition is asymptomatic until at an advanced stage.  Presenting symptoms may include haematuria (blood in urine), flank pain and weight loss, but these may have other causes. An abdominal mass may be found on examination. The condition may be found incidentally on imaging performed for other reasons.  Delays in diagnosis are common.  Clinical onset may coincide with the time of diagnosis, or it may be possible to backdate clinical onset based on preceding symptoms or findings.

Clinical worsening

The only SOP worsening factor is for inability to obtain appropriate clinical management.  Renal cancer has a variable course and prognosis.  It is amenable to treatment if found early.  A delay in appropriate treatment could result in worsening of the condition.  Establishing whether worsening beyond the normal course of the disease has occurred will generally require expert medical opinion.