C38.1
C38.1: Malignant neoplasm of anterior mediastinum
Billable / specific codeICD-10-CM
C38.1 is a billable, specific ICD-10-CM code for malignant neoplasm of anterior mediastinum. It is valid for submission on a claim.
Check C38.1 with the rest of the claim: free scrubberOther codes that can never be billed with C38.1
Their own Excludes1 notes name this code, so the conflict is not listed above.
- 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. Look up the whole chart to see which of its HCCs the hierarchy would zero.
Medicare coverage
C38.1 is named in 54 Medicare coverage policies: 54 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- 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
- A55717Billing and Coding: Lab: Flow Cytometry
Code history
Unchanged in every release from FY2024 to FY2027.