2027 ICD-10-CM Diagnosis Code C7A.098Malignant carcinoid tumors of other sites
ICD-10-CM Codes›C00–D49›C7A›C7A
- Billable — Valid for Submission
- CC — Complication or Comorbidity
- Risk Adjusts — HCC 21
- Chronic Condition
C7A.098 is a billable ICD-10-CM diagnosis code for malignant carcinoid tumors of other sites. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 826 through 830, 843 through 845. As a secondary diagnosis, it counts as a complication or comorbidity (CC) and moves an inpatient stay to a higher severity level within its MS-DRG family. It does not count, however, when the principal diagnosis is one of 38 closely related codes. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Malignant neuroendocrine tumors.
For Medicare Advantage risk adjustment, C7A.098 maps to CMS-HCC Category 21 (Lymphoma and Other Cancers) under the V28 model, adding a risk factor of about 0.671 for a community, non-dual, aged beneficiary in payment year 2027.
Code Identity
Code Classification
Medicare Risk Adjustment (HCC)Billing
C7A.098 maps to a payment category in the CMS-HCC model used to risk-adjust Medicare Advantage payments. Weights are the published community factors for payment year 2027.
Source: CMS Payment Year 2027 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Carcinoma of nasal cavity
- Carcinoma of peritoneum
- Malignant neoplasm of ampulla of Vater
- Malignant neoplasm of hepatic duct
- Malignant neuroendocrine neoplasm of nasal cavity
- Metastatic well-differentiated neuroendocrine neoplasm to peritoneum
- Metastatic well-differentiated neuroendocrine tumor
- Neoplasm of cystic duct
- Neuroendocrine neoplasm of duodenum
- Neuroendocrine neoplasm of gallbladder
- Neuroendocrine neoplasm of liver
- Primary malignant neoplasm of ampulla of Vater
- Primary malignant neoplasm of anal canal
- Primary malignant neoplasm of common bile duct
- Primary malignant neoplasm of cystic duct
- Primary malignant neoplasm of duodenum
- Primary malignant neoplasm of pancreatic duct
- Primary malignant neuroendocrine neoplasm of ampulla of Vater
- Primary malignant neuroendocrine neoplasm of anal canal
- Primary malignant neuroendocrine neoplasm of anus
- Primary malignant neuroendocrine neoplasm of biliary tract
- Primary malignant neuroendocrine neoplasm of cystic duct
- Primary malignant neuroendocrine neoplasm of distal bile duct
- Primary malignant neuroendocrine neoplasm of duodenum
- Primary malignant neuroendocrine neoplasm of esophagus
- Primary malignant neuroendocrine neoplasm of pancreas
- Primary well-differentiated neuroendocrine tumor of ampulla of Vater
- Primary well-differentiated neuroendocrine tumor of anal canal
- Primary well-differentiated neuroendocrine tumor of anus
- Primary well-differentiated neuroendocrine tumor of biliary tract
- Primary well-differentiated neuroendocrine tumor of cystic duct
- Primary well-differentiated neuroendocrine tumor of distal bile duct
- Primary well-differentiated neuroendocrine tumor of duodenum
- Primary well-differentiated neuroendocrine tumor of esophagus
- Primary well-differentiated neuroendocrine tumor of pancreas
- Primary well-differentiated neuroendocrine tumor of perihilar bile duct
- Primary well-differentiated neuroendocrine tumor of small intestine
- Well-differentiated neuroendocrine tumor of ampulla of Vater
- Well-differentiated neuroendocrine tumor of anus
- Well-differentiated neuroendocrine tumor of corpus uteri
- Well-differentiated neuroendocrine tumor of duodenum
- Well-differentiated neuroendocrine tumor of gallbladder
- Well-differentiated neuroendocrine tumor of liver
- Well-differentiated neuroendocrine tumor of nasal cavity
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to C7A.098: its own notes plus those printed at C7A and Chapter 2. A note printed at a category, block or chapter applies to every code under it.
Excludes2
Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.
Use Additional Code
Add a second code, after this one, to fully describe the condition.
Code Also
A second code may be needed to fully describe the condition; the note gives no sequencing direction.
Notes
General instructions on how these codes are used.
- Functional activity
- All neoplasms are classified in this chapter, whether they are functionally active or not. An additional code from Chapter 4 may be used, to identify functional activity associated with any neoplasm.
- Morphology [Histology]
- Chapter 2 classifies neoplasms primarily by site (topography), with broad groupings for behavior, malignant, in situ, benign, etc. The Table of Neoplasms should be used to identify the correct topography code. In a few cases, such as for malignant melanoma and certain neuroendocrine tumors, the morphology (histologic type) is included in the category and codes.
- Primary malignant neoplasms overlapping site boundaries
- A primary malignant neoplasm that overlaps two or more contiguous (next to each other) sites should be classified to the subcategory/code .8 ('overlapping lesion'), unless the combination is specifically indexed elsewhere. For multiple neoplasms of the same site that are not contiguous, such as tumors in different quadrants of the same breast, codes for each site should be assigned.
- Malignant neoplasm of ectopic tissue
- Malignant neoplasms of ectopic tissue are to be coded to the site mentioned, e.g., ectopic pancreatic malignant neoplasms are coded to pancreas, unspecified (C25.9).
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name C7A.098, its category, or a range that includes it.
Applicable To 2
These notes mention C7A.098.
Excludes1 2
These codes carry an Excludes1 note naming C7A.098: they are not reported together with it, unless the two conditions are unrelated.
Index to Diseases and InjuriesGuidance
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
Carcinoid Tumors
Carcinoid tumors are rare, slow-growing cancers. They usually start in the lining of the digestive tract or in the lungs. They grow slowly and don't produce symptoms in the early stages. As a result, the average age of people diagnosed with digestive or lung carcinoids is about 60.
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert C7A.098 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About C7A.098Overview
What is the ICD-10 code for malignant carcinoid tumors of other sites?
The ICD-10-CM code for malignant carcinoid tumors of other sites is C7A.098 (sometimes written as C7A098). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is C7A.098 (Malignant carcinoid tumors of other sites) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report malignant carcinoid tumors of other sites on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does C7A.098 group to?
When malignant carcinoid tumors of other sites is the principal diagnosis on an inpatient stay, it groups to MS-DRG 844, 827, 829, 843, 828, 826, 830, 845, with relative weights from 0.8443 to 4.7560 depending on complications. Higher weights mean higher Medicare reimbursement.
Is C7A.098 a CC or MCC?
CMS lists C7A.098 as a CC (complication or comorbidity) for FY 2027. Reported as a secondary diagnosis, it moves the inpatient stay to a higher-weighted DRG within its severity family. It does not count when the principal diagnosis is one of the 38 closely related codes in its exclusion list.
Does C7A.098 need an additional code?
When the condition applies, yes. The Use Additional Code note at C7A, which applies to C7A.098, reads: code to identify any associated endocrine syndrome, such as: carcinoid syndrome (E34.00). The additional code is reported after C7A.098.
What HCC is C7A.098?
C7A.098 (malignant carcinoid tumors of other sites) maps to CMS-HCC Category 21 (Lymphoma and Other Cancers), commonly written as HCC 21, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2027. It mapped to HCC 12 under the retired V24 model. It also maps in the PACE (CMS-HCC V22), ESRD (V21), and ESRD (V24) models. In the Part D prescription drug model it maps to RxHCC 22.
Does C7A.098 risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, C7A.098 adds a risk adjustment factor of about 0.671 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.493 to 0.739 depending on the payment segment). A more severe related category (HCC 17, HCC 18, HCC 19, and HCC 20) supersedes it when both are reported. See the full factor table on the HCC 21 category page.
