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

ICD-10 C57.20

Billable / Specific HCC v28: 10

Malignant neoplasm of unspecified round ligament

C57
Block
0
Synonyms
430
LCDs
29
Payer Policies
0
Linked CPTs

About ICD-10-CM C57.20

ICD-10-CM code C57.20 represents Malignant neoplasm of unspecified round ligament. This is a billable/specific code in the chapter (block C57). The 2026 edition of ICD-10-CM C57.20 became effective on October 1, 2025.

Coding Tips for C57.20

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

HCC capture: document with MEAT each year

C57.20 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.

Medicare Advantage HCC Impact

CMS-HCC v28 (current)
Category 10
ESRD-HCC
Category 10
RxHCC (Part D)
Category 10

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 C57.20

Local Coverage Determinations (LCDs) from CMS MACs that list C57.20 as a covered diagnosis.

430 LCDs

Showing top 10 of 430 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 C57.20.

29 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
Billing and Coding: Biomarkers for Oncology
Policy ID: ART-52986
Billing and Coding: White Cell Colony Stimulating Factors
Policy ID: ART-56748

CPT Codes Commonly Billed with C57.20

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

No procedure linkages on file for C57.20

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 C57.20 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
C57.20 1835 10000

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

ICD-10 C57.20, Billing FAQ

Is ICD-10 code C57.20 billable? +

Yes, C57.20 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

Does C57.20 affect Medicare Advantage HCC risk adjustment? +

Yes. C57.20 maps to CMS-HCC v28 category 10. Capture this diagnosis annually for accurate Medicare Advantage risk score.

What ICD-9 codes does C57.20 map to? +

Per CMS GEMs, C57.20 maps to ICD-9 codes: 1835. 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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