Is C78.1 a billable ICD-10-CM code?

Yes. C78.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does C78.1 sit in the tabular list?

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

C78.1

C78.1 — Secondary malignant neoplasm of mediastinum

Billable / specific codeICD-10-CM

C78.1 is a billable, specific ICD-10-CM code for secondary malignant neoplasm of mediastinum. It is valid for submission on a claim.

Risk adjustment

C78.1 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:

HCC 17 Cancer Metastatic to Lung, Liver, Brain, and Other Organs; Acute Myeloid Leukemia Except Promyelocytic4.209 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

C78.1 is named in 43 Medicare coverage policies — 43 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 C78. If C78.1 is not quite right, the correct code is usually one of these.

Questions about C78.1

Is C78.1 a billable ICD-10-CM code?: Yes. C78.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does C78.1 sit in the tabular list?: Neoplasms (C00-D49), in the block Malignant neoplasms of ill-defined, other secondary and unspecified sites (C76-C80).