C02.4
C02.4: Malignant neoplasm of lingual tonsil
Billable / specific codeICD-10-CM
C02.4 is a billable, specific ICD-10-CM code for malignant neoplasm of lingual tonsil. It is valid for submission on a claim.
Check C02.4 with the rest of the claim: free scrubberExcludes2: 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.
- malignant neoplasm of tonsil NOS (C09.9)
Risk adjustment
C02.4 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 21 Lymphoma and Other Cancers0.671 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score. Look up the whole chart to see which of its HCCs the hierarchy would zero.
Medicare coverage
C02.4 is named in 56 Medicare coverage policies: 56 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A52450Billing and Coding: Paclitaxel (e.g., Taxol®/Abraxane ™)
- A52479Oral Anticancer Drugs - Policy Article
- A52480Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) - Policy Article
- A54768Billing and Coding: Cardiac Blood Pool Imaging (Multiple Gated Acquisition Scanning- MUGA, Ventriculography) When Performed in Conjunction with Cardiotoxic Chemotherapy
Code history
Unchanged in every release from FY2024 to FY2027.
Other codes under C02
- C02.0Malignant neoplasm of dorsal surface of tongue
- C02.1Malignant neoplasm of border of tongue
- C02.2Malignant neoplasm of ventral surface of tongue
- C02.3Malignant neoplasm of anterior two-thirds of tongue, part unspecified
- C02.8Malignant neoplasm of overlapping sites of tongue
- C02.9Malignant neoplasm of tongue, unspecified