C15-C26 — Malignant neoplasms of digestive organs
ICD-10-CM codes C15-C26 cover malignant neoplasms of digestive organs, within neoplasms. The block holds 69 codes across 12 categories, of which 60 are billable and 9 are header codes that cannot be submitted on a claim.
Excludes1 — never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
- Kaposi's sarcoma of gastrointestinal sites (C46.4)
Excludes2 — not included here, but may coexist
The excluded condition is not part of this code, but a patient can have both. You may code both.
- gastrointestinal stromal tumors (C49.A-)
Risk adjustment in C15-C26
0 codes in this block map to a CMS-HCC, which means the diagnosis carries a risk-adjustment payment when it is documented and coded. Under-coding here is money left on the table; over-coding here is what audits are for.
- HCC 20 Lung and Other Severe Cancers
- HCC 22 Bladder, Colorectal, and Other Cancers
What else to watch in C15-C26
- 60 codes are named in Medicare coverage policies. An LCD or NCD lists them as supporting medical necessity, or explicitly as not supporting it. Which applies depends on the MAC for your state.
Categories in C15-C26
- C15Malignant neoplasm of esophagus
- C16Malignant neoplasm of stomach
- C17Malignant neoplasm of small intestine
- C18Malignant neoplasm of colon
- C19Malignant neoplasm of rectosigmoid junction
- C20Malignant neoplasm of rectum
- C21Malignant neoplasm of anus and anal canal
- C22Malignant neoplasm of liver and intrahepatic bile ducts
- C23Malignant neoplasm of gallbladder
- C24Malignant neoplasm of other and unspecified parts of biliary tract
- C25Malignant neoplasm of pancreas
- C26Malignant neoplasm of other and ill-defined digestive organs