ICD-10 C47.0
Billable / Specific HCC v28: 10 CCMalignant neoplasm of peripheral nerves of head, face and neck
About ICD-10-CM C47.0
ICD-10-CM code C47.0 represents Malignant neoplasm of peripheral nerves of head, face and neck. This is a billable/specific code in the Neoplasms chapter (block C47). The 2026 edition of ICD-10-CM C47.0 became effective on October 1, 2025.
Coding Tips for C47.0
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
C47.0 is a CMS-HCC v28 risk-adjustment code (category 10). 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.
C47.0 is designated CC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-CC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag CC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.
Type 1 Excludes
Pure excludes, these codes can never be coded together with C47.0. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- malignant neoplasm of peripheral nerves of orbit (C69.6-)
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.
Inpatient DRG Impact, CC
codes Malignant neoplasm of peripheral nerves of head, face and neck. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.
Medicare LCD Coverage for C47.0
Local Coverage Determinations (LCDs) from CMS MACs that list C47.0 as a covered diagnosis.
Showing top 10 of 1,050 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing C47.0.
2 Aetna
1 Cigna
5 Medicare
CPT Codes Commonly Billed with C47.0
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 76536 CMS LCD: Billing and Coding: Ultrasound, Soft Tissues of Head and Neck CMS LCD
- 92285 CMS LCD: Billing and Coding: Ocular Photography - External CMS LCD
- 67921 CMS LCD: Billing and Coding: Blepharoplasty CMS LCD
- 67915 CMS LCD: Billing and Coding: Blepharoplasty CMS LCD
- 67922 CMS LCD: Billing and Coding: Blepharoplasty CMS LCD
- 67924 CMS LCD: Billing and Coding: Blepharoplasty CMS LCD
- 67911 CMS LCD: Billing and Coding: Blepharoplasty CMS LCD
- 67917 CMS LCD: Billing and Coding: Blepharoplasty CMS LCD
- 67923 CMS LCD: Billing and Coding: Blepharoplasty CMS LCD
- 67914 CMS LCD: Billing and Coding: Blepharoplasty CMS LCD
Convert C47.0 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 |
|---|---|---|
| C47.0 | 1710 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To C47.0
Other codes in section C45-C49 (Malignant neoplasms of mesothelial and soft tissue).
ICD-10 C47.0, Billing FAQ
Is ICD-10 code C47.0 billable? +
Yes, C47.0 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
What codes are Type 1 Excludes for C47.0? +
Type 1 Excludes (never code together with C47.0): malignant neoplasm of peripheral nerves of orbit (C69.6-)
Does C47.0 affect Medicare Advantage HCC risk adjustment? +
Yes. C47.0 maps to CMS-HCC v28 category 10. Capture this diagnosis annually for accurate Medicare Advantage risk score.
Is C47.0 a CC or MCC for inpatient DRG? +
Yes, this code is designated as CC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.
What CPT codes are commonly billed with C47.0? +
Procedures frequently paired with C47.0 include: 76536, 92285, 67921, 67915, 67922.
What ICD-9 codes does C47.0 map to? +
Per CMS GEMs, C47.0 maps to ICD-9 codes: 1710. 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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