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

ICD-10 C74.00

Billable / Specific HCC v28: 10 CC

Malignant neoplasm of cortex of unspecified adrenal gland

C74
Block
0
Synonyms
311
LCDs
32
Payer Policies
1
Linked CPTs

About ICD-10-CM C74.00

ICD-10-CM code C74.00 represents Malignant neoplasm of cortex of unspecified adrenal gland. This is a billable/specific code in the chapter (block C74). The 2026 edition of ICD-10-CM C74.00 became effective on October 1, 2025.

Coding Tips for C74.00

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

HCC capture: document with MEAT each year

C74.00 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.

Inpatient DRG impact: CC

C74.00 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.

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.

Inpatient DRG Impact, CC

codes Malignant neoplasm of cortex of unspecified adrenal gland. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.

Medicare LCD Coverage for C74.00

Local Coverage Determinations (LCDs) from CMS MACs that list C74.00 as a covered diagnosis.

311 LCDs

Showing top 10 of 311 total . Click a CPT for full coverage scope.

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 →
CMS LCD: Billing and Coding: MolDX: Non-Next Generation Sequencing Targeted Molecular Panel Tests for Predictive Testing in Cancer
Article ID: 60309, Effective: , 680 covered, 0 non-covered
CPT 81479 →
CMS LCD: Billing and Coding: MolDX: Plasma-Based Genomic Profiling in Solid Tumors
Article ID: 57867, Effective: 2025-07-01 00:00:00, 622 covered, 0 non-covered
CPT 0179U →
CMS LCD: Billing and Coding: MolDX: Plasma-Based Genomic Profiling in Solid Tumors
Article ID: 57867, Effective: 2025-07-01 00:00:00, 622 covered, 0 non-covered
CPT 81479 →
CMS LCD: Billing and Coding: MolDX: Plasma-Based Genomic Profiling in Solid Tumors
Article ID: 57867, Effective: 2025-07-01 00:00:00, 622 covered, 0 non-covered
CPT 81462 →
CMS LCD: Billing and Coding: MolDX: Plasma-Based Genomic Profiling in Solid Tumors
Article ID: 57867, Effective: 2025-07-01 00:00:00, 622 covered, 0 non-covered
CPT 81445 →
CMS LCD: Billing and Coding: MolDX: Plasma-Based Genomic Profiling in Solid Tumors
Article ID: 57867, Effective: 2025-07-01 00:00:00, 622 covered, 0 non-covered
CPT 0571U →
CMS LCD: Billing and Coding: MolDX: Plasma-Based Genomic Profiling in Solid Tumors
Article ID: 57867, Effective: 2025-07-01 00:00:00, 622 covered, 0 non-covered
CPT 0485U →
CMS LCD: Billing and Coding: MolDX: Plasma-Based Genomic Profiling in Solid Tumors
Article ID: 57867, Effective: 2025-07-01 00:00:00, 622 covered, 0 non-covered
CPT 81463 →
CMS LCD: Billing and Coding: MolDX: Plasma-Based Genomic Profiling in Solid Tumors
Article ID: 57867, Effective: 2025-07-01 00:00:00, 622 covered, 0 non-covered
CPT 81464 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing C74.00.

32 policies

2 Aetna

Aldesleukin (Proleukin) - Medical Clinical Policy Bulletins | Aetna
Policy ID: CPB-0024
Positron Emission Tomography (PET) - Medical Clinical Policy Bulletins | Aetna
Policy ID: CPB-0071

5 Medicare

Oral Anticancer Drugs - Policy Article
Policy ID: ART-52479
Billing and Coding: White Cell Colony Stimulating Factors
Policy ID: ART-56748
Billing and Coding: Proton Beam Therapy
Policy ID: ART-56827
Billing and Coding: Genomic Sequence Analysis Panels in the Treatment of Solid Organ Neoplasms
Policy ID: ART-56867
Billing and Coding: Stereotactic Radiation Therapy: Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiation Therapy (SBRT)
Policy ID: ART-56874

CPT Codes Commonly Billed with C74.00

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

1 linkages
  • 76536 CMS LCD: Billing and Coding: Ultrasound, Soft Tissues of Head and Neck CMS LCD

Convert C74.00 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
C74.00 1940 10000

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

ICD-10 C74.00, Billing FAQ

Is ICD-10 code C74.00 billable? +

Yes, C74.00 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

Does C74.00 affect Medicare Advantage HCC risk adjustment? +

Yes. C74.00 maps to CMS-HCC v28 category 10. Capture this diagnosis annually for accurate Medicare Advantage risk score.

Is C74.00 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 C74.00? +

Procedures frequently paired with C74.00 include: 76536.

What ICD-9 codes does C74.00 map to? +

Per CMS GEMs, C74.00 maps to ICD-9 codes: 1940. 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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