C69.21
C69.21: Malignant neoplasm of right retina
Billable / specific codeICD-10-CMright
C69.21 is a billable, specific ICD-10-CM code for malignant neoplasm of right retina. It is valid for submission on a claim.
Check C69.21 with the rest of the claim: free scrubberExcludes1 inherited from the categories above C69.21
A category’s note binds every code beneath it.
Written on C69.2: Malignant neoplasm of retina
Risk adjustment
C69.21 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 23 Prostate, Breast, and Other Cancers and Tumors0.186 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
C69.21 is named in 68 Medicare coverage policies: 68 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
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- A52986Billing and Coding: Biomarkers for Oncology
- A53060Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
Code history
Unchanged in every release from FY2024 to FY2027.