Is C69.22 a billable ICD-10-CM code?

Yes. C69.22 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does C69.22 sit in the tabular list?

Neoplasms (C00-D49), in the block Malignant neoplasms of eye, brain and other parts of central nervous system (C69-C72).

What cannot be coded together with C69.22?

C69.22 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above C69.22 (C69.2, C69) and apply to it just the same.

C69.22

C69.22 — Malignant neoplasm of left retina

Billable / specific codeICD-10-CMleft

C69.22 is a billable, specific ICD-10-CM code for malignant neoplasm of left retina. It is valid for submission on a claim.

Excludes1 inherited from the categories above C69.22

These are not written on C69.22, but they bind it: a note on a category applies to every code beneath it. Billing C69.22 with anything listed here is a denial.

Written on C69.2 — Malignant neoplasm of retina

dark area on retina (D49.81)
neoplasm of unspecified behavior of retina and choroid (D49.81)
retinal freckle (D49.81)

Written on C69 — Malignant neoplasm of eye and adnexa

malignant neoplasm of connective tissue of eyelid (C49.0)
malignant neoplasm of eyelid (skin) (C43.1-, C44.1-)
malignant neoplasm of optic nerve (C72.3-)

Risk adjustment

C69.22 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.

Medicare coverage

C69.22 is named in 76 Medicare coverage policies — 76 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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Code history

C69.22 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share C69.2. If C69.22 is not quite right, the correct code is usually one of these.

Questions about C69.22

Is C69.22 a billable ICD-10-CM code?: Yes. C69.22 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does C69.22 sit in the tabular list?: Neoplasms (C00-D49), in the block Malignant neoplasms of eye, brain and other parts of central nervous system (C69-C72).
What cannot be coded together with C69.22?: C69.22 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above C69.22 (C69.2, C69) and apply to it just the same.