C20
C20 — Malignant neoplasm of rectum
Billable / specific codeICD-10-CM
C20 is a billable, specific ICD-10-CM code for malignant neoplasm of rectum. It is valid for submission on a claim.
Excludes1 — 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.
Medicare coverage
C20 is named in 112 Medicare coverage policies — 112 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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Questions about C20
- Is C20 a billable ICD-10-CM code?
- Yes. C20 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does C20 sit in the tabular list?
- Neoplasms (C00-D49), in the block Malignant neoplasms of digestive organs (C15-C26).
- What cannot be coded together with C20?
- C20 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.