C24.1
C24.1 — Malignant neoplasm of ampulla of Vater
Billable / specific codeICD-10-CM
C24.1 is a billable, specific ICD-10-CM code for malignant neoplasm of ampulla of vater. It is valid for submission on a claim.
Risk adjustment
C24.1 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.
Medicare coverage
C24.1 is named in 67 Medicare coverage policies — 67 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A52370Billing and Coding: Bevacizumab and biosimilars
- A52450Billing and Coding: Paclitaxel (e.g., Taxol®/Abraxane ™)
- A52450Billing and Coding: Paclitaxel (e.g., Taxol®/Abraxane ™)
- A52479Oral Anticancer Drugs - Policy Article
Related codes at this level
Codes that share C24. If C24.1 is not quite right, the correct code is usually one of these.
Questions about C24.1
- Is C24.1 a billable ICD-10-CM code?
- Yes. C24.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does C24.1 sit in the tabular list?
- Neoplasms (C00-D49), in the block Malignant neoplasms of digestive organs (C15-C26).