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

ICD-10 C45.9

Billable / Specific HCC v28: 9

Mesothelioma, unspecified

C45
Block
0
Synonyms
464
LCDs
37
Payer Policies
18
Linked CPTs

About ICD-10-CM C45.9

ICD-10-CM code C45.9 represents Mesothelioma, unspecified. This is a billable/specific code in the Neoplasms chapter (block C45). The 2026 edition of ICD-10-CM C45.9 became effective on October 1, 2025.

Coding Tips for C45.9

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

HCC capture: document with MEAT each year

C45.9 is a CMS-HCC v28 risk-adjustment code (category 9). 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 9
ESRD-HCC
Category 9
RxHCC (Part D)
Category 9

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 C45.9

Local Coverage Determinations (LCDs) from CMS MACs that list C45.9 as a covered diagnosis.

464 LCDs

Showing top 10 of 464 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 C45.9.

37 policies

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: Biomarkers for Oncology
Policy ID: ART-52986
Billing and Coding: MolDX: bioTheranostics Cancer TYPE ID� Update
Policy ID: ART-53101

CPT Codes Commonly Billed with C45.9

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

18 linkages
  • 77063 CMS LCD: Billing and Coding: Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography CMS LCD
  • 19030 CMS LCD: Billing and Coding: Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography CMS LCD
  • 76641 CMS LCD: Billing and Coding: Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography CMS LCD
  • G0279 CMS LCD: Billing and Coding: Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography CMS LCD
  • 77048 CMS LCD: Billing and Coding: Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography CMS LCD
  • 77047 CMS LCD: Billing and Coding: Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography CMS LCD
  • 77054 CMS LCD: Billing and Coding: Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography CMS LCD
  • C8906 CMS LCD: Billing and Coding: Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography CMS LCD
  • 76642 CMS LCD: Billing and Coding: Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography CMS LCD
  • 77067 CMS LCD: Billing and Coding: Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography CMS LCD

Convert C45.9 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
C45.9 1991 10000

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

ICD-10 C45.9, Billing FAQ

Is ICD-10 code C45.9 billable? +

Yes, C45.9 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

Does C45.9 affect Medicare Advantage HCC risk adjustment? +

Yes. C45.9 maps to CMS-HCC v28 category 9. Capture this diagnosis annually for accurate Medicare Advantage risk score.

What CPT codes are commonly billed with C45.9? +

Procedures frequently paired with C45.9 include: 77063, 19030, 76641, G0279, 77048.

What ICD-9 codes does C45.9 map to? +

Per CMS GEMs, C45.9 maps to ICD-9 codes: 1991. 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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