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

ICD-10 C53.1

Billable / Specific HCC v28: 11

Malignant neoplasm of exocervix

C53
Block
0
Synonyms
806
LCDs
47
Payer Policies
6
Linked CPTs

About ICD-10-CM C53.1

ICD-10-CM code C53.1 represents Malignant neoplasm of exocervix. This is a billable/specific code in the chapter (block C53). The 2026 edition of ICD-10-CM C53.1 became effective on October 1, 2025.

Coding Tips for C53.1

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

HCC capture: document with MEAT each year

C53.1 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.

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 C53.1

Local Coverage Determinations (LCDs) from CMS MACs that list C53.1 as a covered diagnosis.

806 LCDs

Showing top 10 of 806 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 C53.1.

47 policies

5 Medicare

Billing and Coding: Bevacizumab and biosimilars
Policy ID: ART-52370
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: 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 C53.1

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

6 linkages
  • C9726 CMS LCD: Billing and Coding: Intraoperative Radiation Therapy CMS LCD
  • 19294 CMS LCD: Billing and Coding: Intraoperative Radiation Therapy CMS LCD
  • 76145 CMS LCD: Billing and Coding: Intraoperative Radiation Therapy CMS LCD
  • 77469 CMS LCD: Billing and Coding: Intraoperative Radiation Therapy CMS LCD
  • 77425 CMS LCD: Billing and Coding: Intraoperative Radiation Therapy CMS LCD
  • 77424 CMS LCD: Billing and Coding: Intraoperative Radiation Therapy CMS LCD

Convert C53.1 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
C53.1 1801 00000

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

ICD-10 C53.1, Billing FAQ

Is ICD-10 code C53.1 billable? +

Yes, C53.1 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

Does C53.1 affect Medicare Advantage HCC risk adjustment? +

Yes. C53.1 maps to CMS-HCC v28 category 11. Capture this diagnosis annually for accurate Medicare Advantage risk score.

What CPT codes are commonly billed with C53.1? +

Procedures frequently paired with C53.1 include: C9726, 19294, 76145, 77469, 77425.

What ICD-9 codes does C53.1 map to? +

Per CMS GEMs, C53.1 maps to ICD-9 codes: 1801. 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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