C48.1
C48.1 — Malignant neoplasm of specified parts of peritoneum
Billable / specific codeICD-10-CM
C48.1 is a billable, specific ICD-10-CM code for malignant neoplasm of specified parts of peritoneum. It is valid for submission on a claim.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Malignant neoplasm of cul-de-sac
- Malignant neoplasm of mesentery
- Malignant neoplasm of mesocolon
- Malignant neoplasm of omentum
- Malignant neoplasm of parietal peritoneum
- Malignant neoplasm of pelvic peritoneum
Risk adjustment
C48.1 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
C48.1 is named in 104 Medicare coverage policies — 104 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A52370Billing and Coding: Bevacizumab and biosimilars
- A52450Billing and Coding: Paclitaxel (e.g., Taxol®/Abraxane ™)
- A52450Billing and Coding: Paclitaxel (e.g., Taxol®/Abraxane ™)
- A52453Billing and Coding: Luteinizing Hormone-Releasing Hormone (LHRH) Analogs
Related codes at this level
Codes that share C48. If C48.1 is not quite right, the correct code is usually one of these.
Questions about C48.1
- Is C48.1 a billable ICD-10-CM code?
- Yes. C48.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does C48.1 sit in the tabular list?
- Neoplasms (C00-D49), in the block Malignant neoplasms of mesothelial and soft tissue (C45-C49).