C7B.04 — Secondary carcinoid tumors of peritoneum
C7B.04 is a billable, specific ICD-10-CM code for secondary carcinoid tumors of peritoneum. It is valid for submission on a claim.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Mesentery metastasis of carcinoid tumor
Other codes that can never be billed with C7B.04
These codes carry an Excludes1 note pointing at C7B.04. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading C7B.04 alone.
Risk adjustment
C7B.04 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
C7B.04 is named in 28 Medicare coverage policies — 28 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 C7B.04 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 C7B.04.
- Tumor›carcinoid›mesentery metastasis
- Tumor›carcinoid›secondary›peritoneum
- Tumor›secondary›carcinoid›peritoneum
Related codes at this level
Codes that share C7B.0. If C7B.04 is not quite right, the correct code is usually one of these.
Questions about C7B.04
- Is C7B.04 a billable ICD-10-CM code?
- Yes. C7B.04 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does C7B.04 sit in the tabular list?
- Neoplasms (C00-D49), in the block Secondary neuroendocrine tumors (C7B).