C19: Malignant neoplasm of rectosigmoid junction
C19 is a billable, specific ICD-10-CM code for malignant neoplasm of rectosigmoid junction. It is valid for submission on a claim.
Check C19 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.
- malignant carcinoid tumors of the colon (C7A.02-)
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Malignant neoplasm of colon with rectum
- Malignant neoplasm of rectosigmoid (colon)
Other codes that can never be billed with C19
Their own Excludes1 notes name this code, so the conflict is not listed above.
- C18.7Malignant neoplasm of sigmoid colon
Risk adjustment
C19 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 22 Bladder, Colorectal, and Other Cancers0.363 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
C19 is named in 82 Medicare coverage policies: 82 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A52370Billing and Coding: Bevacizumab and biosimilars
- A52479Oral Anticancer Drugs - Policy Article
- A52480Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) - Policy Article
- A52986Billing and Coding: Biomarkers for Oncology
Code history
Unchanged in every release from FY2024 to FY2027.