ICD Body System
Date amended:
Statements of Principles
Current RMA Instruments
Reasonable Hypothesis
83 of 2019
Balance of Probabilities
84 of 2019
Changes from previous Instruments


ICD Codes
  • ICD-9-CM: 188,233.7
  • ICD-10-AM: C67, D09.0
Brief description

This is a primary cancer of the lining of the bladder.

Confirming the diagnosis

The diagnosis requires confirmation by histology.

The relevant medical specialist is a urologist.

Diagnoses covered by SOP
  • Adenocarcinoma of the bladder
  • Carcinoma-in-situ of the bladder
  • Malignant neoplasm of the ureteric orifice or urethral orifice of the bladder
  • Squamous cell carcinoma of the bladder
  • Transitional cell carcinoma of the bladder
  • Undifferentiated carcinoma of the bladder
Conditions that may be covered by SOP (further information required)
  • Bladder cancer
Conditions excluded from SOP
  • Carcinoid of the bladder#
  • Hodgkin's lymphoma of the bladder*
  • Malignant neoplasm of the prostate*
  • Malignant neoplasm of the urethra*
  • Non-Hodgkin lymphoma of the bladder*
  • Soft tissue sarcoma of the bladder*

* another SOP applies

#Non-SOP condition

Clinical onset

The most common presentation is painless haematuria (blood in the urine), either visible or detected on testing.  However, haematuria in most cases is due to a benign cause.  Other symptoms of bladder cancer are also similar to those of benign urinary disorders.  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.  Bladder cancer has a very 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.