C16.0 — Malignant neoplasm of cardia
C16.0 is a billable, specific ICD-10-CM code for malignant neoplasm of cardia. 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 cardiac orifice
- Malignant neoplasm of cardio-esophageal junction
- Malignant neoplasm of esophagus and stomach
- Malignant neoplasm of gastro-esophageal junction
Excludes2 inherited from the categories above C16.0
Also inherited, and the opposite of Excludes1: these conditions are not part of C16.0, but a patient can have both, so you may code both.
Written on C16 — Malignant neoplasm of stomach
- malignant carcinoid tumor of the stomach (C7A.092)
Other codes that can never be billed with C16.0
These codes carry an Excludes1 note pointing at C16.0. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading C16.0 alone.
- C15.5Malignant neoplasm of lower third of esophagus
Risk adjustment
C16.0 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 20 Lung and Other Severe Cancers1.136 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
C16.0 is named in 80 Medicare coverage policies — 80 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
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Code history
C16.0 has not changed since FY2024 — no addition, revision or deletion across the FY2024–FY2027 ICD-10-CM releases.
Related codes at this level
Codes that share C16. If C16.0 is not quite right, the correct code is usually one of these.
- C16.1Malignant neoplasm of fundus of stomach
- C16.2Malignant neoplasm of body of stomach
- C16.3Malignant neoplasm of pyloric antrum
- C16.4Malignant neoplasm of pylorus
- C16.5Malignant neoplasm of lesser curvature of stomach, unspecified
- C16.6Malignant neoplasm of greater curvature of stomach, unspecified
- C16.8Malignant neoplasm of overlapping sites of stomach
- C16.9Malignant neoplasm of stomach, unspecified
Questions about C16.0
- Is C16.0 a billable ICD-10-CM code?
- Yes. C16.0 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does C16.0 sit in the tabular list?
- Neoplasms (C00-D49), in the block Malignant neoplasms of digestive organs (C15-C26).