C7A.026
C7A.026: Malignant carcinoid tumor of the rectum
Billable / specific codeICD-10-CM
C7A.026 is a billable, specific ICD-10-CM code for malignant carcinoid tumor of the rectum. It is valid for submission on a claim.
Check C7A.026 with the rest of the claim: free scrubberOther codes that can never be billed with C7A.026
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
C7A.026 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. Look up the whole chart to see which of its HCCs the hierarchy would zero.
Medicare coverage
C7A.026 is named in 53 Medicare coverage policies: 53 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A52479Oral Anticancer Drugs - Policy Article
- A52480Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) - Policy Article
- A52986Billing and Coding: Biomarkers for Oncology
- A53095Billing and Coding: Lab: Bladder/Urothelial Tumor Markers
Alphabetic index entries that lead here
- Tumor›carcinoid›malignant›rectum
Code history
Unchanged in every release from FY2024 to FY2027.
Other codes under C7A.02
- C7A.020Malignant carcinoid tumor of the appendix
- C7A.021Malignant carcinoid tumor of the cecum
- C7A.022Malignant carcinoid tumor of the ascending colon
- C7A.023Malignant carcinoid tumor of the transverse colon
- C7A.024Malignant carcinoid tumor of the descending colon
- C7A.025Malignant carcinoid tumor of the sigmoid colon
- C7A.029Malignant carcinoid tumor of the large intestine, unspecified portion