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ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 C01

Billable / Specific HCC v28: 11

Malignant neoplasm of base of tongue

C01
Block
3
Synonyms
983
LCDs
50
Payer Policies
229
Linked CPTs

About ICD-10-CM C01

ICD-10-CM code C01 represents Malignant neoplasm of base of tongue. This is a billable/specific code in the Neoplasms chapter (block C01). The 2026 edition of ICD-10-CM C01 became effective on October 1, 2025.

Coding Tips for C01

Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.

HCC capture: document with MEAT each year

C01 is a CMS-HCC v28 risk-adjustment code (category 11). To count for the patient Risk Adjustment Factor (RAF), document the diagnosis with MEAT language each calendar year: Monitored, Evaluated, Assessed, Treated. A diagnosis on the problem list alone does not satisfy CMS RADV audit standards. Include the diagnosis in the assessment with current status and current treatment plan.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under C01. Per CMS ICD-10-CM Tabular 2026.

  • Malignant neoplasm of dorsal surface of base of tongue
  • Malignant neoplasm of fixed part of tongue NOS
  • Malignant neoplasm of posterior third of tongue

Use Additional Code

When coding C01, also report these additional codes when applicable.

  • code to identify:
  • alcohol abuse and dependence (F10.-)
  • history of tobacco dependence (Z87.891)
  • tobacco dependence (F17.-)
  • tobacco use (Z72.0)

Medicare Advantage HCC Impact

CMS-HCC v28 (current)
Category 11
ESRD-HCC
Category 11
RxHCC (Part D)
Category 11

Capture this diagnosis annually for accurate risk adjustment. Missed HCC captures are the #1 revenue leak in Medicare Advantage risk programs.

Medicare LCD Coverage for C01

Local Coverage Determinations (LCDs) from CMS MACs that list C01 as a covered diagnosis.

983 LCDs

Showing top 10 of 983 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Radiation Therapies
Article ID: 59350, Effective: 2026-01-01 00:00:00, 757 covered, 0 non-covered
CPT 77402 →
CMS LCD: Billing and Coding: Radiation Therapies
Article ID: 59350, Effective: 2026-01-01 00:00:00, 757 covered, 0 non-covered
CPT 77371 →
CMS LCD: Billing and Coding: Radiation Therapies
Article ID: 59350, Effective: 2026-01-01 00:00:00, 757 covered, 0 non-covered
CPT 61797 →
CMS LCD: Billing and Coding: Radiation Therapies
Article ID: 59350, Effective: 2026-01-01 00:00:00, 757 covered, 0 non-covered
CPT G0339 →
CMS LCD: Billing and Coding: Radiation Therapies
Article ID: 59350, Effective: 2026-01-01 00:00:00, 757 covered, 0 non-covered
CPT 77338 →
CMS LCD: Billing and Coding: Radiation Therapies
Article ID: 59350, Effective: 2026-01-01 00:00:00, 757 covered, 0 non-covered
CPT 77432 →
CMS LCD: Billing and Coding: Radiation Therapies
Article ID: 59350, Effective: 2026-01-01 00:00:00, 757 covered, 0 non-covered
CPT 61800 →
CMS LCD: Billing and Coding: Radiation Therapies
Article ID: 59350, Effective: 2026-01-01 00:00:00, 757 covered, 0 non-covered
CPT 77372 →
CMS LCD: Billing and Coding: Radiation Therapies
Article ID: 59350, Effective: 2026-01-01 00:00:00, 757 covered, 0 non-covered
CPT 77435 →
CMS LCD: Billing and Coding: Radiation Therapies
Article ID: 59350, Effective: 2026-01-01 00:00:00, 757 covered, 0 non-covered
CPT 77407 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing C01.

50 policies

3 Cigna

Electroencephalography - (0521)
Policy ID: MM_0521
Head and Neck Ultrasound - (0549)
Policy ID: MM_0549
Neuropsychological Testing - (EN0258)
Policy ID: EN_MM_0258

5 Medicare

Billing and Coding: Paclitaxel (e.g., Taxol�/Abraxane �)
Policy ID: ART-52450
Oral Anticancer Drugs - Policy Article
Policy ID: ART-52479
Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) - Policy Article
Policy ID: ART-52480
Billing and Coding: Cardiac Blood Pool Imaging (Multiple Gated Acquisition Scanning- MUGA, Ventriculography) When Performed in Conjunction with Cardiotoxic Chemotherapy
Policy ID: ART-54768
Billing and Coding: Proton Beam Therapy
Policy ID: ART-55315

CPT Codes Commonly Billed with C01

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

229 linkages
  • 63621 CMS LCD: Billing and Coding: Stereotactic Radiation Therapy: Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiation Therapy (SBRT) CMS LCD
  • 61800 CMS LCD: Billing and Coding: Stereotactic Radiation Therapy: Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiation Therapy (SBRT) CMS LCD
  • 77373 CMS LCD: Billing and Coding: Stereotactic Radiation Therapy: Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiation Therapy (SBRT) CMS LCD
  • G0339 CMS LCD: Billing and Coding: Stereotactic Radiation Therapy: Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiation Therapy (SBRT) CMS LCD
  • 77372 CMS LCD: Billing and Coding: Stereotactic Radiation Therapy: Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiation Therapy (SBRT) CMS LCD
  • G0563 CMS LCD: Billing and Coding: Stereotactic Radiation Therapy: Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiation Therapy (SBRT) CMS LCD
  • 77435 CMS LCD: Billing and Coding: Stereotactic Radiation Therapy: Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiation Therapy (SBRT) CMS LCD
  • 77371 CMS LCD: Billing and Coding: Stereotactic Radiation Therapy: Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiation Therapy (SBRT) CMS LCD
  • G0340 CMS LCD: Billing and Coding: Stereotactic Radiation Therapy: Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiation Therapy (SBRT) CMS LCD
  • 61798 CMS LCD: Billing and Coding: Stereotactic Radiation Therapy: Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiation Therapy (SBRT) CMS LCD

Convert C01 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
C01 1410 00000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 C01, Billing FAQ

Is ICD-10 code C01 billable? +

Yes, C01 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What other names or terms map to C01? +

ICD-10 C01 includes: Malignant neoplasm of dorsal surface of base of tongue; Malignant neoplasm of fixed part of tongue NOS; Malignant neoplasm of posterior third of tongue.

Does C01 affect Medicare Advantage HCC risk adjustment? +

Yes. C01 maps to CMS-HCC v28 category 11. Capture this diagnosis annually for accurate Medicare Advantage risk score.

What CPT codes are commonly billed with C01? +

Procedures frequently paired with C01 include: 63621, 61800, 77373, G0339, 77372.

What ICD-9 codes does C01 map to? +

Per CMS GEMs, C01 maps to ICD-9 codes: 1410. Useful for legacy data review and historical claim analysis.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on July 16, 2026.

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