C7B.1: Secondary Merkel cell carcinoma
C7B.1 is a billable, specific ICD-10-CM code for secondary merkel cell carcinoma. It is valid for submission on a claim.
Check C7B.1 with the rest of the claim: free scrubberInclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Merkel cell carcinoma nodal presentation
- Merkel cell carcinoma visceral metastatic presentation
Other codes that can never be billed with C7B.1
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
C7B.1 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. Look up the whole chart to see which of its HCCs the hierarchy would zero.
Medicare coverage
C7B.1 is named in 23 Medicare coverage policies: 23 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
- A54768Billing and Coding: Cardiac Blood Pool Imaging (Multiple Gated Acquisition Scanning- MUGA, Ventriculography) When Performed in Conjunction with Cardiotoxic Chemotherapy
Alphabetic index entries that lead here
- Carcinoma›Merkel cell›nodal presentation
- Carcinoma›Merkel cell›secondary
- Carcinoma›Merkel cell›visceral metastatic
- Carcinoma›secondary›Merkel cell
Code history
Unchanged in every release from FY2024 to FY2027.