ICD-10 C56.9
Billable / Specific HCC v28: 10 CCMalignant neoplasm of unspecified ovary
About ICD-10-CM C56.9
ICD-10-CM code C56.9 represents Malignant neoplasm of unspecified ovary. This is a billable/specific code in the chapter (block C56). The 2026 edition of ICD-10-CM C56.9 became effective on October 1, 2025.
Coding Tips for C56.9
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
C56.9 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.
C56.9 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.
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 unspecified ovary. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.
Medicare LCD Coverage for C56.9
Local Coverage Determinations (LCDs) from CMS MACs that list C56.9 as a covered diagnosis.
Showing top 10 of 1,065 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing C56.9.
5 Medicare
CPT Codes Commonly Billed with C56.9
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- J1952 CMS LCD: Billing and Coding: Luteinizing Hormone-Releasing Hormone (LHRH) Analogs CMS LCD
- J3316 CMS LCD: Billing and Coding: Luteinizing Hormone-Releasing Hormone (LHRH) Analogs CMS LCD
- 96402 CMS LCD: Billing and Coding: Luteinizing Hormone-Releasing Hormone (LHRH) Analogs CMS LCD
- J9219 CMS LCD: Billing and Coding: Luteinizing Hormone-Releasing Hormone (LHRH) Analogs CMS LCD
- J9225 CMS LCD: Billing and Coding: Luteinizing Hormone-Releasing Hormone (LHRH) Analogs CMS LCD
- J9218 CMS LCD: Billing and Coding: Luteinizing Hormone-Releasing Hormone (LHRH) Analogs CMS LCD
- J1950 CMS LCD: Billing and Coding: Luteinizing Hormone-Releasing Hormone (LHRH) Analogs CMS LCD
- J1954 CMS LCD: Billing and Coding: Luteinizing Hormone-Releasing Hormone (LHRH) Analogs CMS LCD
- 11983 CMS LCD: Billing and Coding: Luteinizing Hormone-Releasing Hormone (LHRH) Analogs CMS LCD
- 11982 CMS LCD: Billing and Coding: Luteinizing Hormone-Releasing Hormone (LHRH) Analogs CMS LCD
Convert C56.9 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 |
|---|---|---|
| C56.9 | 1830 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To C56.9
Other codes in section C51-C58 (Malignant neoplasms of female genital organs).
ICD-10 C56.9, Billing FAQ
Is ICD-10 code C56.9 billable? +
Yes, C56.9 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
Does C56.9 affect Medicare Advantage HCC risk adjustment? +
Yes. C56.9 maps to CMS-HCC v28 category 10. Capture this diagnosis annually for accurate Medicare Advantage risk score.
Is C56.9 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 C56.9? +
Procedures frequently paired with C56.9 include: J1952, J3316, 96402, J9219, J9225.
What ICD-9 codes does C56.9 map to? +
Per CMS GEMs, C56.9 maps to ICD-9 codes: 1830. 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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