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

ICD-10 C7B.8

Billable / Specific HCC v28: 8

Other secondary neuroendocrine tumors

C7B
Block
0
Synonyms
529
LCDs
24
Payer Policies
8
Linked CPTs

About ICD-10-CM C7B.8

ICD-10-CM code C7B.8 represents Other secondary neuroendocrine tumors. This is a billable/specific code in the Neoplasms chapter (block C7B). The 2026 edition of ICD-10-CM C7B.8 became effective on October 1, 2025.

Coding Tips for C7B.8

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

HCC capture: document with MEAT each year

C7B.8 is a CMS-HCC v28 risk-adjustment code (category 8). 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 8
ESRD-HCC
Category 8
RxHCC (Part D)
Category 8

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 C7B.8

Local Coverage Determinations (LCDs) from CMS MACs that list C7B.8 as a covered diagnosis.

529 LCDs

Showing top 10 of 529 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Peripheral Nerve Blocks
Article ID: 57452, Effective: 2025-10-01 00:00:00, 1570 covered, 0 non-covered
CPT 64420 →
CMS LCD: Billing and Coding: Peripheral Nerve Blocks
Article ID: 57452, Effective: 2025-10-01 00:00:00, 1570 covered, 0 non-covered
CPT 20561 →
CMS LCD: Billing and Coding: Peripheral Nerve Blocks
Article ID: 57452, Effective: 2025-10-01 00:00:00, 1570 covered, 0 non-covered
CPT 64415 →
CMS LCD: Billing and Coding: Peripheral Nerve Blocks
Article ID: 57452, Effective: 2025-10-01 00:00:00, 1570 covered, 0 non-covered
CPT 64447 →
CMS LCD: Billing and Coding: Peripheral Nerve Blocks
Article ID: 57452, Effective: 2025-10-01 00:00:00, 1570 covered, 0 non-covered
CPT 64448 →
CMS LCD: Billing and Coding: Peripheral Nerve Blocks
Article ID: 57452, Effective: 2025-10-01 00:00:00, 1570 covered, 0 non-covered
CPT 64416 →
CMS LCD: Billing and Coding: Peripheral Nerve Blocks
Article ID: 57452, Effective: 2025-10-01 00:00:00, 1570 covered, 0 non-covered
CPT 64405 →
CMS LCD: Billing and Coding: Peripheral Nerve Blocks
Article ID: 57452, Effective: 2025-10-01 00:00:00, 1570 covered, 0 non-covered
CPT 64454 →
CMS LCD: Billing and Coding: Peripheral Nerve Blocks
Article ID: 57452, Effective: 2025-10-01 00:00:00, 1570 covered, 0 non-covered
CPT 64425 →
CMS LCD: Billing and Coding: Peripheral Nerve Blocks
Article ID: 57452, Effective: 2025-10-01 00:00:00, 1570 covered, 0 non-covered
CPT 64450 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing C7B.8.

24 policies

5 Medicare

Oral Anticancer Drugs - Policy Article
Policy ID: ART-52479
Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) - Policy Article
Policy ID: ART-52480
Billing and Coding: Biomarkers for Oncology
Policy ID: ART-52986
Billing and Coding: Lab: Bladder/Urothelial Tumor Markers
Policy ID: ART-53095
Billing and Coding: MolDX: bioTheranostics Cancer TYPE ID� Update
Policy ID: ART-53101

CPT Codes Commonly Billed with C7B.8

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

8 linkages
  • 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 C7B.8 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
C7B.8 20979 10000

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

ICD-10 C7B.8, Billing FAQ

Is ICD-10 code C7B.8 billable? +

Yes, C7B.8 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

Does C7B.8 affect Medicare Advantage HCC risk adjustment? +

Yes. C7B.8 maps to CMS-HCC v28 category 8. Capture this diagnosis annually for accurate Medicare Advantage risk score.

What CPT codes are commonly billed with C7B.8? +

Procedures frequently paired with C7B.8 include: 76770, 76776, 76775, 88120, 86386.

What ICD-9 codes does C7B.8 map to? +

Per CMS GEMs, C7B.8 maps to ICD-9 codes: 20979. 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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