Is C76.3 a billable ICD-10-CM code?

Yes. C76.3 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does C76.3 sit in the tabular list?

Neoplasms (C00-D49), in the block Malignant neoplasms of ill-defined, other secondary and unspecified sites (C76-C80).

C76.3

C76.3 — Malignant neoplasm of pelvis

Billable / specific codeICD-10-CM

C76.3 is a billable, specific ICD-10-CM code for malignant neoplasm of pelvis. It is valid for submission on a claim.

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Malignant neoplasm of groin NOS
Malignant neoplasm of sites overlapping systems within the pelvis
Rectovaginal (septum) malignant neoplasm
Rectovesical (septum) malignant neoplasm

Risk adjustment

C76.3 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

C76.3 is named in 57 Medicare coverage policies — 57 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
A53101Billing and Coding: MolDX: bioTheranostics Cancer TYPE ID® Update
A54188Billing and Coding: MolDX: bioTheranostics Cancer TYPE ID®
A54386Billing and Coding: MolDX: bioTheranostics Cancer TYPE ID® Update

Related codes at this level

Codes that share C76. If C76.3 is not quite right, the correct code is usually one of these.

Questions about C76.3

Is C76.3 a billable ICD-10-CM code?: Yes. C76.3 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does C76.3 sit in the tabular list?: Neoplasms (C00-D49), in the block Malignant neoplasms of ill-defined, other secondary and unspecified sites (C76-C80).