Is C78.4 a billable ICD-10-CM code?

Yes. C78.4 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does C78.4 sit in the tabular list?

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

What cannot be coded together with C78.4?

C78.4 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above C78.4 (C78) and apply to it just the same.

C78.4

C78.4 — Secondary malignant neoplasm of small intestine

Billable / specific codeICD-10-CM

C78.4 is a billable, specific ICD-10-CM code for secondary malignant neoplasm of small intestine. It is valid for submission on a claim.

Excludes1 inherited from the categories above C78.4

These are not written on C78.4, but they bind it: a note on a category applies to every code beneath it. Billing C78.4 with anything listed here is a denial.

Written on C78 — Secondary malignant neoplasm of respiratory and digestive organs

secondary carcinoid tumors of liver (C7B.02)
secondary carcinoid tumors of peritoneum (C7B.04)

Excludes2 inherited from the categories above C78.4

Also inherited, and the opposite of Excludes1: these conditions are not part of C78.4, but a patient can have both, so you may code both.

Written on C78 — Secondary malignant neoplasm of respiratory and digestive organs

lymph node metastases (C77.0)

Risk adjustment

C78.4 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

C78.4 is named in 54 Medicare coverage policies — 54 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

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A53101Billing and Coding: MolDX: bioTheranostics Cancer TYPE ID® Update
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Code history

C78.4 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share C78. If C78.4 is not quite right, the correct code is usually one of these.

Questions about C78.4

Is C78.4 a billable ICD-10-CM code?: Yes. C78.4 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does C78.4 sit in the tabular list?: Neoplasms (C00-D49), in the block Malignant neoplasms of ill-defined, other secondary and unspecified sites (C76-C80).
What cannot be coded together with C78.4?: C78.4 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above C78.4 (C78) and apply to it just the same.