ICD-10 C13.1
Billable / Specific HCC v28: 11Malignant neoplasm of aryepiglottic fold, hypopharyngeal aspect
About ICD-10-CM C13.1
ICD-10-CM code C13.1 represents Malignant neoplasm of aryepiglottic fold, hypopharyngeal aspect. This is a billable/specific code in the Neoplasms chapter (block C13). The 2026 edition of ICD-10-CM C13.1 became effective on October 1, 2025.
Coding Tips for C13.1
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
C13.1 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 C13.1. Per CMS ICD-10-CM Tabular 2026.
- Malignant neoplasm of aryepiglottic fold, marginal zone
- Malignant neoplasm of aryepiglottic fold NOS
- Malignant neoplasm of interarytenoid fold, marginal zone
- Malignant neoplasm of interarytenoid fold NOS
Type 2 Excludes
Not included here, the excluded code is not part of C13.1, but a patient may have both conditions at the same time. Both codes may be coded together when applicable.
- malignant neoplasm of aryepiglottic fold or interarytenoid fold, laryngeal aspect (C32.1)
Medicare Advantage HCC Impact
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 C13.1
Local Coverage Determinations (LCDs) from CMS MACs that list C13.1 as a covered diagnosis.
Showing top 10 of 990 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing C13.1.
5 Medicare
CPT Codes Commonly Billed with C13.1
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 83735 CMS LCD: Billing and Coding: Magnesium CMS LCD
- 97130 CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders CMS LCD
- 92608 CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders CMS LCD
- 97129 CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders CMS LCD
- 92607 CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders CMS LCD
- 96110 CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders CMS LCD
- 92524 CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders CMS LCD
- 92508 CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders CMS LCD
- 92597 CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders CMS LCD
- 92521 CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders CMS LCD
Convert C13.1 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| C13.1 | 1482 | 00000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To C13.1
Other codes in section C00-C14 (Malignant neoplasms of lip, oral cavity and pharynx).
ICD-10 C13.1, Billing FAQ
Is ICD-10 code C13.1 billable? +
Yes, C13.1 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 C13.1? +
ICD-10 C13.1 includes: Malignant neoplasm of aryepiglottic fold, marginal zone; Malignant neoplasm of aryepiglottic fold NOS; Malignant neoplasm of interarytenoid fold, marginal zone, and 1 more clinical synonyms.
What codes are Type 2 Excludes for C13.1? +
Type 2 Excludes (may be coded together when both conditions exist): malignant neoplasm of aryepiglottic fold or interarytenoid fold, laryngeal aspect (C32.1)
Does C13.1 affect Medicare Advantage HCC risk adjustment? +
Yes. C13.1 maps to CMS-HCC v28 category 11. Capture this diagnosis annually for accurate Medicare Advantage risk score.
What CPT codes are commonly billed with C13.1? +
Procedures frequently paired with C13.1 include: 83735, 97130, 92608, 97129, 92607.
What ICD-9 codes does C13.1 map to? +
Per CMS GEMs, C13.1 maps to ICD-9 codes: 1482. 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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