C79.81 — Secondary malignant neoplasm of breast
C79.81 is a billable, specific ICD-10-CM code for secondary malignant neoplasm of breast. It is valid for submission on a claim.
Risk adjustment
C79.81 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 18 Cancer Metastatic to Bone, Other and Unspecified Metastatic Cancer; Acute Leukemia Except Myeloid2.341 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
C79.81 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.
- A52478External Breast Prostheses - Policy Article
- A52480Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) - Policy Article
- A52849Billing and Coding: Breast Imaging: Breast Echography (Sonography)/Breast MRI/Ductography
- A53101Billing and Coding: MolDX: bioTheranostics Cancer TYPE ID® Update
How C79.81 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to C79.81.
- Melanoma›metastatic›breast
Related codes at this level
Codes that share C79.8. If C79.81 is not quite right, the correct code is usually one of these.
Questions about C79.81
- Is C79.81 a billable ICD-10-CM code?
- Yes. C79.81 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does C79.81 sit in the tabular list?
- Neoplasms (C00-D49), in the block Malignant neoplasms of ill-defined, other secondary and unspecified sites (C76-C80).