C17.3: Meckel's diverticulum, malignant
C17.3 is a billable, specific ICD-10-CM code for meckel's diverticulum, malignant. It is valid for submission on a claim.
Check C17.3 with the rest of the claim: free scrubberExcludes1: never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
- Meckel's diverticulum, congenital (Q43.0)
Excludes1 inherited from the categories above C17.3
A category’s note binds every code beneath it.
Written on C17: Malignant neoplasm of small intestine
- malignant carcinoid tumors of the small intestine (C7A.01)
Risk adjustment
C17.3 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
C17.3 is named in 58 Medicare coverage policies: 58 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A52370Billing and Coding: Bevacizumab and biosimilars
- A52450Billing and Coding: Paclitaxel (e.g., Taxol®/Abraxane ™)
- A52479Oral Anticancer Drugs - Policy Article
- A52480Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) - Policy Article
Code history
Unchanged in every release from FY2024 to FY2027.