C09.9

C09.9: Malignant neoplasm of tonsil, unspecified

Billable / specific codeICD-10-CM

C09.9 is a billable, specific ICD-10-CM code for malignant neoplasm of tonsil, unspecified. It is valid for submission on a claim.

Check C09.9 with the rest of the claim: free scrubber

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Malignant neoplasm of tonsil NOS
Malignant neoplasm of faucial tonsils
Malignant neoplasm of palatine tonsils

Excludes2 inherited from the categories above C09.9

Not part of this code, but both may be coded when both are present.

Written on C09: Malignant neoplasm of tonsil

malignant neoplasm of lingual tonsil (C02.4)
malignant neoplasm of pharyngeal tonsil (C11.1)

Risk adjustment

C09.9 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. Look up the whole chart to see which of its HCCs the hierarchy would zero.

Medicare coverage

C09.9 is named in 48 Medicare coverage policies: 48 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

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Code history

Unchanged in every release from FY2024 to FY2027.