ICD-10 C52
Billable / Specific HCC v28: 11Malignant neoplasm of vagina
About ICD-10-CM C52
ICD-10-CM code C52 represents Malignant neoplasm of vagina. This is a billable/specific code in the chapter (block C52). The 2026 edition of ICD-10-CM C52 became effective on October 1, 2025.
Coding Tips for C52
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
C52 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.
Type 1 Excludes
Pure excludes, these codes can never be coded together with C52. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- carcinoma in situ of vagina (D07.2)
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 C52
Local Coverage Determinations (LCDs) from CMS MACs that list C52 as a covered diagnosis.
Showing top 10 of 854 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing C52.
5 Medicare
CPT Codes Commonly Billed with C52
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.
Convert C52 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 |
|---|---|---|
| C52 | 1840 | 00000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To C52
Other codes in section C51-C58 (Malignant neoplasms of female genital organs).
ICD-10 C52, Billing FAQ
Is ICD-10 code C52 billable? +
Yes, C52 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 C52? +
Type 1 Excludes (never code together with C52): carcinoma in situ of vagina (D07.2)
Does C52 affect Medicare Advantage HCC risk adjustment? +
Yes. C52 maps to CMS-HCC v28 category 11. Capture this diagnosis annually for accurate Medicare Advantage risk score.
What ICD-9 codes does C52 map to? +
Per CMS GEMs, C52 maps to ICD-9 codes: 1840. 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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