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

ICD-10 C07

Billable / Specific HCC v28: 11

Malignant neoplasm of parotid gland

C07
Block
0
Synonyms
940
LCDs
49
Payer Policies
196
Linked CPTs

About ICD-10-CM C07

ICD-10-CM code C07 represents Malignant neoplasm of parotid gland. This is a billable/specific code in the Neoplasms chapter (block C07). The 2026 edition of ICD-10-CM C07 became effective on October 1, 2025.

Coding Tips for C07

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

HCC capture: document with MEAT each year

C07 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.

Use Additional Code

When coding C07, also report these additional codes when applicable.

  • code to identify:
  • alcohol abuse and dependence (F10.-)
  • exposure to environmental tobacco smoke (Z77.22)
  • exposure to tobacco smoke in the perinatal period (P96.81)
  • history of tobacco dependence (Z87.891)
  • occupational exposure to environmental tobacco smoke (Z57.31)
  • 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 C07

Local Coverage Determinations (LCDs) from CMS MACs that list C07 as a covered diagnosis.

940 LCDs

Showing top 10 of 940 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 C07.

49 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
Billing and Coding: Luteinizing Hormone-Releasing Hormone (LHRH) Analogs
Policy ID: ART-52453
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

CPT Codes Commonly Billed with C07

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

196 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 C07 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
C07 1420 00000

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

ICD-10 C07, Billing FAQ

Is ICD-10 code C07 billable? +

Yes, C07 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

Does C07 affect Medicare Advantage HCC risk adjustment? +

Yes. C07 maps to CMS-HCC v28 category 11. Capture this diagnosis annually for accurate Medicare Advantage risk score.

What CPT codes are commonly billed with C07? +

Procedures frequently paired with C07 include: 63621, 61800, 77373, G0339, 77372.

What ICD-9 codes does C07 map to? +

Per CMS GEMs, C07 maps to ICD-9 codes: 1420. 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 May 31, 2026.

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