ICD-10 C67.9
Billable / Specific HCC v28: 11Malignant neoplasm of bladder, unspecified
About ICD-10-CM C67.9
ICD-10-CM code C67.9 represents Malignant neoplasm of bladder, unspecified. This is a billable/specific code in the chapter (block C67). The 2026 edition of ICD-10-CM C67.9 became effective on October 1, 2025.
Coding Tips for C67.9
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
C67.9 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
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 C67.9
Local Coverage Determinations (LCDs) from CMS MACs that list C67.9 as a covered diagnosis.
Showing top 10 of 684 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing C67.9.
1 Aetna
5 Medicare
CPT Codes Commonly Billed with C67.9
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 52000 Cystoscopy diagnostic — bladder neck obstruction, cystitis, hematuria, hydronephrosis, bladder cancer, BPH, urinary retention, urethral stricture, poor stream, bladder calculus Urology
- 76857 Pelvic ultrasound non-OB — BPH, urinary retention, hematuria, poor stream, hydronephrosis, bladder cancer, pelvic pain, cystitis Urology
- 76770 CMS LCD: Billing and Coding: Retroperitoneal Ultrasound CMS LCD
- 76776 CMS LCD: Billing and Coding: Retroperitoneal Ultrasound CMS LCD
- 76775 CMS LCD: Billing and Coding: Retroperitoneal Ultrasound CMS LCD
- 88120 CMS LCD: Billing and Coding: Lab: Bladder/Urothelial Tumor Markers CMS LCD
- 86386 CMS LCD: Billing and Coding: Lab: Bladder/Urothelial Tumor Markers CMS LCD
- 86294 CMS LCD: Billing and Coding: Lab: Bladder/Urothelial Tumor Markers CMS LCD
- 86316 CMS LCD: Billing and Coding: Lab: Bladder/Urothelial Tumor Markers CMS LCD
- 88121 CMS LCD: Billing and Coding: Lab: Bladder/Urothelial Tumor Markers CMS LCD
Convert C67.9 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 |
|---|---|---|
| C67.9 | 1889 | 00000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To C67.9
Other codes in section C64-C68 (Malignant neoplasms of urinary tract).
ICD-10 C67.9, Billing FAQ
Is ICD-10 code C67.9 billable? +
Yes, C67.9 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
Does C67.9 affect Medicare Advantage HCC risk adjustment? +
Yes. C67.9 maps to CMS-HCC v28 category 11. Capture this diagnosis annually for accurate Medicare Advantage risk score.
What CPT codes are commonly billed with C67.9? +
Procedures frequently paired with C67.9 include: 52000, 76857, 76770, 76776, 76775.
What ICD-9 codes does C67.9 map to? +
Per CMS GEMs, C67.9 maps to ICD-9 codes: 1889. 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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