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

ICD-10 C62.91

Billable / Specific HCC v28: 12

Malignant neoplasm of right testis, unspecified whether descended or undescended

C62
Block
0
Synonyms
372
LCDs
30
Payer Policies
0
Linked CPTs

About ICD-10-CM C62.91

ICD-10-CM code C62.91 represents Malignant neoplasm of right testis, unspecified whether descended or undescended. This is a billable/specific code in the chapter (block C62). The 2026 edition of ICD-10-CM C62.91 became effective on October 1, 2025.

Coding Tips for C62.91

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

HCC capture: document with MEAT each year

C62.91 is a CMS-HCC v28 risk-adjustment code (category 12). 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 12
ESRD-HCC
Category 12
RxHCC (Part D)
Category 12

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 C62.91

Local Coverage Determinations (LCDs) from CMS MACs that list C62.91 as a covered diagnosis.

372 LCDs

Showing top 10 of 372 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 C62.91.

30 policies

5 Medicare

Billing and Coding: Paclitaxel (e.g., Taxol�/Abraxane �)
Policy ID: ART-52450
Oral Anticancer Drugs - Policy Article
Policy ID: ART-52479
Billing and Coding: CT of the Abdomen and Pelvis
Policy ID: ART-56421
Billing and Coding: Erythropoiesis Stimulating Agents (ESA)
Policy ID: ART-56462
Billing and Coding: Computerized Axial Tomography (CT), Thorax
Policy ID: ART-56580

CPT Codes Commonly Billed with C62.91

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

No procedure linkages on file for C62.91

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 C62.91 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
C62.91 1869 10000

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

ICD-10 C62.91, Billing FAQ

Is ICD-10 code C62.91 billable? +

Yes, C62.91 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

Does C62.91 affect Medicare Advantage HCC risk adjustment? +

Yes. C62.91 maps to CMS-HCC v28 category 12. Capture this diagnosis annually for accurate Medicare Advantage risk score.

What ICD-9 codes does C62.91 map to? +

Per CMS GEMs, C62.91 maps to ICD-9 codes: 1869. 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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