C38.1 — Malignant neoplasm of anterior mediastinum
C38.1 is a billable, specific ICD-10-CM code for malignant neoplasm of anterior mediastinum. It is valid for submission on a claim.
Other codes that can never be billed with C38.1
These codes carry an Excludes1 note pointing at C38.1. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading C38.1 alone.
- C49.3Malignant neoplasm of connective and soft tissue of thorax
Risk adjustment
C38.1 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.
Medicare coverage
C38.1 is named in 53 Medicare coverage policies — 53 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
- A54768Billing and Coding: Cardiac Blood Pool Imaging (Multiple Gated Acquisition Scanning- MUGA, Ventriculography) When Performed in Conjunction with Cardiotoxic Chemotherapy
Related codes at this level
Codes that share C38. If C38.1 is not quite right, the correct code is usually one of these.
Questions about C38.1
- Is C38.1 a billable ICD-10-CM code?
- Yes. C38.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does C38.1 sit in the tabular list?
- Neoplasms (C00-D49), in the block Malignant neoplasms of respiratory and intrathoracic organs (C30-C39).