C31.1 — Malignant neoplasm of ethmoidal sinus
C31.1 is a billable, specific ICD-10-CM code for malignant neoplasm of ethmoidal sinus. It is valid for submission on a claim.
Risk adjustment
C31.1 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 21 Lymphoma and Other Cancers0.671 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
C31.1 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.
- A52450Billing and Coding: Paclitaxel (e.g., Taxol®/Abraxane ™)
- A52479Oral Anticancer Drugs - Policy Article
- A52479Oral Anticancer Drugs - Policy Article
- A52479Oral Anticancer Drugs - Policy Article
Code history
C31.1 has not changed since FY2024 — no addition, revision or deletion across the FY2024–FY2027 ICD-10-CM releases.
Related codes at this level
Codes that share C31. If C31.1 is not quite right, the correct code is usually one of these.
Questions about C31.1
- Is C31.1 a billable ICD-10-CM code?
- Yes. C31.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does C31.1 sit in the tabular list?
- Neoplasms (C00-D49), in the block Malignant neoplasms of respiratory and intrathoracic organs (C30-C39).