C11.3 — Malignant neoplasm of anterior wall of nasopharynx
C11.3 is a billable, specific ICD-10-CM code for malignant neoplasm of anterior wall of nasopharynx. It is valid for submission on a claim.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Malignant neoplasm of floor of nasopharynx
- Malignant neoplasm of nasopharyngeal (anterior) (posterior) surface of soft palate
- Malignant neoplasm of posterior margin of nasal choana
- Malignant neoplasm of posterior margin of nasal septum
Other codes that can never be billed with C11.3
These codes carry an Excludes1 note pointing at C11.3. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading C11.3 alone.
- C30.0Malignant neoplasm of nasal cavity
Risk adjustment
C11.3 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
C11.3 is named in 60 Medicare coverage policies — 60 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
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Related codes at this level
Codes that share C11. If C11.3 is not quite right, the correct code is usually one of these.
Questions about C11.3
- Is C11.3 a billable ICD-10-CM code?
- Yes. C11.3 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does C11.3 sit in the tabular list?
- Neoplasms (C00-D49), in the block Malignant neoplasms of lip, oral cavity and pharynx (C00-C14).