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.
Check C76.1 with the rest of the claim: free scrubberInclusion 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
Excludes1 inherited from the categories above C76.1
A category’s note binds every code beneath it.
Written on C76: Malignant neoplasm of other and ill-defined sites
Other codes that can never be billed with C76.1
Their own Excludes1 notes name this code, so the conflict is not listed above.
- 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. Look up the whole chart to see which of its HCCs the hierarchy would zero.
Medicare coverage
C76.1 is named in 43 Medicare coverage policies: 43 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- 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
Code history
Unchanged in every release from FY2024 to FY2027.