C20: Malignant neoplasm of rectum
C20 is a billable, specific ICD-10-CM code for malignant neoplasm of rectum. It is valid for submission on a claim.
Check C20 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 tumor of the rectum (C7A.026)
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Malignant neoplasm of rectal ampulla
Risk adjustment
C20 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
C20 is named in 83 Medicare coverage policies: 83 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.