Is C38.0 a billable ICD-10-CM code?

Yes. C38.0 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does C38.0 sit in the tabular list?

Neoplasms (C00-D49), in the block Malignant neoplasms of respiratory and intrathoracic organs (C30-C39).

What cannot be coded together with C38.0?

C38.0 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

C38.0

C38.0 — Malignant neoplasm of heart

Billable / specific codeICD-10-CM

C38.0 is a billable, specific ICD-10-CM code for malignant neoplasm of heart. 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 neoplasm of great vessels (C49.3)

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Malignant neoplasm of pericardium

Other codes that can never be billed with C38.0

These codes carry an Excludes1 note pointing at C38.0. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading C38.0 alone.

C45.2Mesothelioma of pericardium
C49.3Malignant neoplasm of connective and soft tissue of thorax

Risk adjustment

C38.0 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

C38.0 is named in 61 Medicare coverage policies — 61 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A52479Oral Anticancer Drugs - Policy Article
A52479Oral Anticancer Drugs - Policy Article
A52480Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) - Policy Article
A52850Billing and Coding: Cardiac Catheterization and Coronary Angiography

Related codes at this level

Codes that share C38. If C38.0 is not quite right, the correct code is usually one of these.

Questions about C38.0

Is C38.0 a billable ICD-10-CM code?: Yes. C38.0 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does C38.0 sit in the tabular list?: Neoplasms (C00-D49), in the block Malignant neoplasms of respiratory and intrathoracic organs (C30-C39).
What cannot be coded together with C38.0?: C38.0 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.