C38.4 — Malignant neoplasm of pleura
C38.4 is a billable, specific ICD-10-CM code for malignant neoplasm of pleura. It is valid for submission on a claim.
Other codes that can never be billed with C38.4
These codes carry an Excludes1 note pointing at C38.4. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading C38.4 alone.
- C45.0Mesothelioma of pleura
Risk adjustment
C38.4 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
C38.4 is named in 63 Medicare coverage policies — 63 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
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Related codes at this level
Codes that share C38. If C38.4 is not quite right, the correct code is usually one of these.
Questions about C38.4
- Is C38.4 a billable ICD-10-CM code?
- Yes. C38.4 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does C38.4 sit in the tabular list?
- Neoplasms (C00-D49), in the block Malignant neoplasms of respiratory and intrathoracic organs (C30-C39).