C49.12
C49.12 — Malignant neoplasm of connective and soft tissue of left upper limb, including shoulder
Billable / specific codeICD-10-CMleft
C49.12 is a billable, specific ICD-10-CM code for malignant neoplasm of connective and soft tissue of left upper limb, including shoulder. It is valid for submission on a claim.
Risk adjustment
C49.12 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
C49.12 is named in 79 Medicare coverage policies — 79 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 ™)
- A52479Oral Anticancer Drugs - Policy Article
- A52479Oral Anticancer Drugs - Policy Article
Related codes at this level
Codes that share C49.1. If C49.12 is not quite right, the correct code is usually one of these.
Questions about C49.12
- Is C49.12 a billable ICD-10-CM code?
- Yes. C49.12 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does C49.12 sit in the tabular list?
- Neoplasms (C00-D49), in the block Malignant neoplasms of mesothelial and soft tissue (C45-C49).