ICD-10 C71.5
Billable / Specific HCC v28: 10 CCMalignant neoplasm of cerebral ventricle
About ICD-10-CM C71.5
ICD-10-CM code C71.5 represents Malignant neoplasm of cerebral ventricle. This is a billable/specific code in the chapter (block C71). The 2026 edition of ICD-10-CM C71.5 became effective on October 1, 2025.
Coding Tips for C71.5
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
C71.5 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.
C71.5 is designated CC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-CC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag CC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.
Type 1 Excludes
Pure excludes, these codes can never be coded together with C71.5. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- malignant neoplasm of fourth cerebral ventricle (C71.7)
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.
Inpatient DRG Impact, CC
codes Malignant neoplasm of cerebral ventricle. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.
Medicare LCD Coverage for C71.5
Local Coverage Determinations (LCDs) from CMS MACs that list C71.5 as a covered diagnosis.
Showing top 10 of 1,574 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing C71.5.
5 Medicare
CPT Codes Commonly Billed with C71.5
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
- 90865 CMS LCD: Billing and Coding: Psychiatric Codes CMS LCD
- 90889 CMS LCD: Billing and Coding: Psychiatric Codes CMS LCD
- G0451 CMS LCD: Billing and Coding: Psychiatric Codes CMS LCD
- 90880 CMS LCD: Billing and Coding: Psychiatric Codes CMS LCD
- 90839 CMS LCD: Billing and Coding: Psychiatric Codes CMS LCD
- G0017 CMS LCD: Billing and Coding: Psychiatric Codes CMS LCD
- 90840 CMS LCD: Billing and Coding: Psychiatric Codes CMS LCD
Convert C71.5 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 |
|---|---|---|
| C71.5 | 1915 | 00000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To C71.5
Other codes in section C69-C72 (Malignant neoplasms of eye, brain and other parts of central nervous system).
ICD-10 C71.5, Billing FAQ
Is ICD-10 code C71.5 billable? +
Yes, C71.5 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 C71.5? +
Type 1 Excludes (never code together with C71.5): malignant neoplasm of fourth cerebral ventricle (C71.7)
Does C71.5 affect Medicare Advantage HCC risk adjustment? +
Yes. C71.5 maps to CMS-HCC v28 category 10. Capture this diagnosis annually for accurate Medicare Advantage risk score.
Is C71.5 a CC or MCC for inpatient DRG? +
Yes, this code is designated as CC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.
What CPT codes are commonly billed with C71.5? +
Procedures frequently paired with C71.5 include: 92083, 92082, 92081, 90865, 90889.
What ICD-9 codes does C71.5 map to? +
Per CMS GEMs, C71.5 maps to ICD-9 codes: 1915. 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 June 1, 2026.
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