C40.20
C40.20: Malignant neoplasm of long bones of unspecified lower limb
Billable / specific codeICD-10-CMunspecified
C40.20 is a billable, specific ICD-10-CM code for malignant neoplasm of long bones of unspecified lower limb. It is valid for submission on a claim.
Check C40.20 with the rest of the claim: free scrubberOther codes that can never be billed with C40.20
Their own Excludes1 notes name this code, so the conflict is not listed above.
- C41Malignant neoplasm of bone and articular cartilage of other and unspecified sites
Risk adjustment
C40.20 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
C40.20 is named in 39 Medicare coverage policies: 39 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A52479Oral Anticancer Drugs - Policy Article
- A55717Billing and Coding: Lab: Flow Cytometry
- A56695Billing and Coding: Implantable Infusion Pump
- A56748Billing and Coding: White Cell Colony Stimulating Factors
Code history
Unchanged in every release from FY2024 to FY2027.