ICD-10 C69.92
Billable / Specific HCC v28: 12Malignant neoplasm of unspecified site of left eye
About ICD-10-CM C69.92
ICD-10-CM code C69.92 represents Malignant neoplasm of unspecified site of left eye. This is a billable/specific code in the chapter (block C69). The 2026 edition of ICD-10-CM C69.92 became effective on October 1, 2025.
Coding Tips for C69.92
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
C69.92 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
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 C69.92
Local Coverage Determinations (LCDs) from CMS MACs that list C69.92 as a covered diagnosis.
Showing top 10 of 477 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing C69.92.
5 Medicare
CPT Codes Commonly Billed with C69.92
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 92083 CMS LCD: Billing and Coding: Visual Field Examination CMS LCD
- 92082 CMS LCD: Billing and Coding: Visual Field Examination CMS LCD
- 92081 CMS LCD: Billing and Coding: Visual Field Examination CMS LCD
- 36226 CMS LCD: Billing and Coding: Thoracic Aortography and Carotid, Vertebral, and Subclavian Angiography CMS LCD
- 36228 CMS LCD: Billing and Coding: Thoracic Aortography and Carotid, Vertebral, and Subclavian Angiography CMS LCD
- 36225 CMS LCD: Billing and Coding: Thoracic Aortography and Carotid, Vertebral, and Subclavian Angiography CMS LCD
- 36224 CMS LCD: Billing and Coding: Thoracic Aortography and Carotid, Vertebral, and Subclavian Angiography CMS LCD
- 36223 CMS LCD: Billing and Coding: Thoracic Aortography and Carotid, Vertebral, and Subclavian Angiography CMS LCD
- 36222 CMS LCD: Billing and Coding: Thoracic Aortography and Carotid, Vertebral, and Subclavian Angiography CMS LCD
- 36227 CMS LCD: Billing and Coding: Thoracic Aortography and Carotid, Vertebral, and Subclavian Angiography CMS LCD
Convert C69.92 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 |
|---|---|---|
| C69.92 | 1909 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To C69.92
Other codes in section C69-C72 (Malignant neoplasms of eye, brain and other parts of central nervous system).
ICD-10 C69.92, Billing FAQ
Is ICD-10 code C69.92 billable? +
Yes, C69.92 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
Does C69.92 affect Medicare Advantage HCC risk adjustment? +
Yes. C69.92 maps to CMS-HCC v28 category 12. Capture this diagnosis annually for accurate Medicare Advantage risk score.
What CPT codes are commonly billed with C69.92? +
Procedures frequently paired with C69.92 include: 92083, 92082, 92081, 36226, 36228.
What ICD-9 codes does C69.92 map to? +
Per CMS GEMs, C69.92 maps to ICD-9 codes: 1909. 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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