C04.9
C04.9 — Malignant neoplasm of floor of mouth, unspecified
Billable / specific codeICD-10-CM
C04.9 is a billable, specific ICD-10-CM code for malignant neoplasm of floor of mouth, unspecified. It is valid for submission on a claim.
Risk adjustment
C04.9 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.
Medicare coverage
C04.9 is named in 43 Medicare coverage policies — 43 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A52450Billing and Coding: Paclitaxel (e.g., Taxol®/Abraxane ™)
- A52479Oral Anticancer Drugs - Policy Article
- A52479Oral Anticancer Drugs - Policy Article
- A52479Oral Anticancer Drugs - Policy Article
Related codes at this level
Codes that share C04. If C04.9 is not quite right, the correct code is usually one of these.
Questions about C04.9
- Is C04.9 a billable ICD-10-CM code?
- Yes. C04.9 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does C04.9 sit in the tabular list?
- Neoplasms (C00-D49), in the block Malignant neoplasms of lip, oral cavity and pharynx (C00-C14).