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Cancer & Metastasis Coding Guide
⭐ HCC-MAPPEDICD-10-CM — follow the decision tree to correctly identify, sequence, and code cancer and metastasis diagnoses. Per §I.C.2 Official Guidelines.
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Active Malignancy Codes Are HCC-Mapped
Nearly all active C-codes carry HCC weight under CMS-HCC v24 and v28. Accurate cancer coding directly impacts Medicare Advantage risk adjustment. The HCC callout boxes below identify which codes are mapped — always verify the specific HCC number and category at point of lookup in Lynceus.
Primary Unknown
C80.1
"Where did it start? Unknown."
⭐ HCC v24: 8 · v28: 17
Secondary Unknown
C79.9
"Where did it spread? Unknown."
⭐ HCC v24: 8 · v28: 17
Chemo Encounter
Z51.11
Sequenced FIRST when visit is for chemo
Not HCC-mapped
Radiation Encounter
Z51.0
Sequenced FIRST when visit is for radiation
Not HCC-mapped
Personal History
Z85.x
Resolved cancer — no active treatment
No HCC weight
Long-term Therapy
Z79.899
Hormone / targeted / immunotherapy add-on
Not HCC-mapped
📖 Per ICD-10-CM Official Guidelines for Coding and Reporting, Section I.C.2 — Neoplasms. This guide reflects current ICD-10-CM coding guidance. Always use the current-year Official Guidelines for Coding and Reporting as the final authority.