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

ICD-10 C02.9

Billable / Specific HCC v28: 11

Malignant neoplasm of tongue, unspecified

C02
Block
0
Synonyms
459
LCDs
39
Payer Policies
87
Linked CPTs

About ICD-10-CM C02.9

ICD-10-CM code C02.9 represents Malignant neoplasm of tongue, unspecified. This is a billable/specific code in the Neoplasms chapter (block C02). The 2026 edition of ICD-10-CM C02.9 became effective on October 1, 2025.

Coding Tips for C02.9

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

HCC capture: document with MEAT each year

C02.9 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.

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 C02.9

Local Coverage Determinations (LCDs) from CMS MACs that list C02.9 as a covered diagnosis.

459 LCDs

Showing top 10 of 459 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: MolDX: Non-Next Generation Sequencing Targeted Molecular Panel Tests for Predictive Testing in Cancer
Article ID: 60240, Effective: , 680 covered, 0 non-covered
CPT 81479 →
CMS LCD: Billing and Coding: MolDX: Non-Next Generation Sequencing Targeted Molecular Panel Tests for Predictive Testing in Cancer
Article ID: 60309, Effective: , 680 covered, 0 non-covered
CPT 81479 →
CMS LCD: Billing and Coding: MolDX: Plasma-Based Genomic Profiling in Solid Tumors
Article ID: 57867, Effective: 2025-07-01 00:00:00, 622 covered, 0 non-covered
CPT 0179U →
CMS LCD: Billing and Coding: MolDX: Plasma-Based Genomic Profiling in Solid Tumors
Article ID: 57867, Effective: 2025-07-01 00:00:00, 622 covered, 0 non-covered
CPT 81479 →
CMS LCD: Billing and Coding: MolDX: Plasma-Based Genomic Profiling in Solid Tumors
Article ID: 57867, Effective: 2025-07-01 00:00:00, 622 covered, 0 non-covered
CPT 81462 →
CMS LCD: Billing and Coding: MolDX: Plasma-Based Genomic Profiling in Solid Tumors
Article ID: 57867, Effective: 2025-07-01 00:00:00, 622 covered, 0 non-covered
CPT 81445 →
CMS LCD: Billing and Coding: MolDX: Plasma-Based Genomic Profiling in Solid Tumors
Article ID: 57867, Effective: 2025-07-01 00:00:00, 622 covered, 0 non-covered
CPT 0571U →
CMS LCD: Billing and Coding: MolDX: Plasma-Based Genomic Profiling in Solid Tumors
Article ID: 57867, Effective: 2025-07-01 00:00:00, 622 covered, 0 non-covered
CPT 0485U →
CMS LCD: Billing and Coding: MolDX: Plasma-Based Genomic Profiling in Solid Tumors
Article ID: 57867, Effective: 2025-07-01 00:00:00, 622 covered, 0 non-covered
CPT 81463 →
CMS LCD: Billing and Coding: MolDX: Plasma-Based Genomic Profiling in Solid Tumors
Article ID: 57867, Effective: 2025-07-01 00:00:00, 622 covered, 0 non-covered
CPT 81464 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing C02.9.

39 policies

1 Cigna

Head and Neck Ultrasound - (0549)
Policy ID: MM_0549

5 Medicare

Billing and Coding: Paclitaxel (e.g., Taxol�/Abraxane �)
Policy ID: ART-52450
Oral Anticancer Drugs - Policy Article
Policy ID: ART-52479
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: Erythropoiesis Stimulating Agents (ESA)
Policy ID: ART-56462
Billing and Coding: Computerized Axial Tomography (CT), Thorax
Policy ID: ART-56580

CPT Codes Commonly Billed with C02.9

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

87 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 C02.9 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
C02.9 1419 00000

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

ICD-10 C02.9, Billing FAQ

Is ICD-10 code C02.9 billable? +

Yes, C02.9 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

Does C02.9 affect Medicare Advantage HCC risk adjustment? +

Yes. C02.9 maps to CMS-HCC v28 category 11. Capture this diagnosis annually for accurate Medicare Advantage risk score.

What CPT codes are commonly billed with C02.9? +

Procedures frequently paired with C02.9 include: 63621, 61800, 77373, G0339, 77372.

What ICD-9 codes does C02.9 map to? +

Per CMS GEMs, C02.9 maps to ICD-9 codes: 1419. 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 June 1, 2026.

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