Is C69.42 a billable ICD-10-CM code?

Yes. C69.42 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does C69.42 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).

C69.42

C69.42 — Malignant neoplasm of left ciliary body

Billable / specific codeICD-10-CMleft

C69.42 is a billable, specific ICD-10-CM code for malignant neoplasm of left ciliary body. It is valid for submission on a claim.

Risk adjustment

C69.42 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

C69.42 is named in 78 Medicare coverage policies — 78 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A52450Billing and Coding: Paclitaxel (e.g., Taxol®/Abraxane ™)
A52450Billing and Coding: Paclitaxel (e.g., Taxol®/Abraxane ™)
A52479Oral Anticancer Drugs - Policy Article
A52480Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) - Policy Article

Related codes at this level

Codes that share C69.4. If C69.42 is not quite right, the correct code is usually one of these.

Questions about C69.42

Is C69.42 a billable ICD-10-CM code?: Yes. C69.42 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does C69.42 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).