C7A.012 — Malignant carcinoid tumor of the ileum
C7A.012 is a billable, specific ICD-10-CM code for malignant carcinoid tumor of the ileum. It is valid for submission on a claim.
Risk adjustment
C7A.012 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 21 Lymphoma and Other Cancers0.671 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
C7A.012 is named in 51 Medicare coverage policies — 51 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A52479Oral Anticancer Drugs - Policy Article
- A52479Oral Anticancer Drugs - Policy Article
- A52480Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) - Policy Article
- A52986Billing and Coding: Biomarkers for Oncology
How C7A.012 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 C7A.012.
- Tumor›carcinoid›malignant›ileum
Related codes at this level
Codes that share C7A.01. If C7A.012 is not quite right, the correct code is usually one of these.
Questions about C7A.012
- Is C7A.012 a billable ICD-10-CM code?
- Yes. C7A.012 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does C7A.012 sit in the tabular list?
- Neoplasms (C00-D49), in the block Malignant neuroendocrine tumors (C7A).