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

ICD-10 C58

Billable / Specific HCC v28: 10

Malignant neoplasm of placenta

C58
Block
0
Synonyms
619
LCDs
41
Payer Policies
4
Linked CPTs

About ICD-10-CM C58

ICD-10-CM code C58 represents Malignant neoplasm of placenta. This is a billable/specific code in the chapter (block C58). The 2026 edition of ICD-10-CM C58 became effective on October 1, 2025.

Coding Tips for C58

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

HCC capture: document with MEAT each year

C58 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.

Type 1 Excludes

Pure excludes, these codes can never be coded together with C58. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • chorioadenoma (destruens) (D39.2)
  • hydatidiform mole NOS (O01.9)
  • invasive hydatidiform mole (D39.2)
  • male choriocarcinoma NOS (C62.9-)
  • malignant hydatidiform mole (D39.2)

Includes

  • choriocarcinoma NOS
  • chorionepithelioma NOS

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 C58

Local Coverage Determinations (LCDs) from CMS MACs that list C58 as a covered diagnosis.

619 LCDs

Showing top 10 of 619 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74170 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74177 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74160 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74178 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74150 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 72194 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74176 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 72192 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 72193 →
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 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing C58.

41 policies

2 Cigna

Flow Cytometry - (0538)
Policy ID: MM_0538
Transthoracic Echocardiography in Children - (0523)
Policy ID: MM_0523

5 Medicare

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
Billing and Coding: Proton Beam Therapy
Policy ID: ART-55315
Billing and Coding: Lab: Flow Cytometry
Policy ID: ART-55717

CPT Codes Commonly Billed with C58

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

4 linkages
  • A9611 CMS LCD: Billing and Coding: Cardiac Radionuclide Imaging CMS LCD
  • A4641 CMS LCD: Billing and Coding: Cardiac Radionuclide Imaging CMS LCD
  • A9555 CMS LCD: Billing and Coding: Cardiac Radionuclide Imaging CMS LCD
  • A9526 CMS LCD: Billing and Coding: Cardiac Radionuclide Imaging CMS LCD

Convert C58 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
C58 181 00000

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

ICD-10 C58, Billing FAQ

Is ICD-10 code C58 billable? +

Yes, C58 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 C58? +

Type 1 Excludes (never code together with C58): chorioadenoma (destruens) (D39.2); hydatidiform mole NOS (O01.9); invasive hydatidiform mole (D39.2)

Does C58 affect Medicare Advantage HCC risk adjustment? +

Yes. C58 maps to CMS-HCC v28 category 10. Capture this diagnosis annually for accurate Medicare Advantage risk score.

What CPT codes are commonly billed with C58? +

Procedures frequently paired with C58 include: A9611, A4641, A9555, A9526.

What ICD-9 codes does C58 map to? +

Per CMS GEMs, C58 maps to ICD-9 codes: 181. 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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