C76.1 — Malignant neoplasm of thorax
C76.1 is a billable, specific ICD-10-CM code for malignant neoplasm of thorax. It is valid for submission on a claim.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Intrathoracic malignant neoplasm NOS
- Malignant neoplasm of axilla NOS
- Thoracic malignant neoplasm NOS
Other codes that can never be billed with C76.1
These codes carry an Excludes1 note pointing at C76.1. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading C76.1 alone.
- C39Malignant neoplasm of other and ill-defined sites in the respiratory system and intrathoracic organs
Risk adjustment
C76.1 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
C76.1 is named in 45 Medicare coverage policies — 45 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A52480Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) - Policy Article
- A54768Billing and Coding: Cardiac Blood Pool Imaging (Multiple Gated Acquisition Scanning- MUGA, Ventriculography) When Performed in Conjunction with Cardiotoxic Chemotherapy
- A55315Billing and Coding: Proton Beam Therapy
- A55717Billing and Coding: Lab: Flow Cytometry
Related codes at this level
Codes that share C76. If C76.1 is not quite right, the correct code is usually one of these.
Questions about C76.1
- Is C76.1 a billable ICD-10-CM code?
- Yes. C76.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does C76.1 sit in the tabular list?
- Neoplasms (C00-D49), in the block Malignant neoplasms of ill-defined, other secondary and unspecified sites (C76-C80).