C7A.026 — Malignant carcinoid tumor of the rectum
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.
Other codes that can never be billed with C7A.026
These codes carry an Excludes1 note pointing at C7A.026. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading C7A.026 alone.
- C20Malignant neoplasm of rectum
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.
Medicare coverage
C7A.026 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.
- 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.026 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.026.
- Tumor›carcinoid›malignant›rectum
Related codes at this level
Codes that share C7A.02. If C7A.026 is not quite right, the correct code is usually one of these.
- 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
Questions about C7A.026
- Is C7A.026 a billable ICD-10-CM code?
- Yes. C7A.026 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does C7A.026 sit in the tabular list?
- Neoplasms (C00-D49), in the block Malignant neuroendocrine tumors (C7A).