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C00 ICD-10-CM Code: Malignant neoplasm of lip

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FY 2026 Apr update / Neoplasms (C00-D49) / Malignant neoplasms of lip, oral cavity and pharynx (C00-C14)

C00

Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidance

Malignant neoplasm of lip

Malignant neoplasm of lip

CMS-HCC V28

0

0

RAF 0

CMS-HCC V24

0

0

RAF 0

ACA/HHS

0

0

RAF 0

ESRD/PACE

0

0

RAF 0

RXHCC

0

0

RAF 0

Code Trumping

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Code Book Path

Official
C0Malignant neoplasms of lip, oral cavity and pharynx (C00-C14)
C00Malignant neoplasm of lip

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for C00 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for C00 in this effective period.

Related Child Codes

Official
C00.0Malignant neoplasm of external upper lip
C00.1Malignant neoplasm of external lower lip
C00.2Malignant neoplasm of external lip, unspecified
C00.3Malignant neoplasm of upper lip, inner aspect
C00.4Malignant neoplasm of lower lip, inner aspect

Includes

Official

ICD-10-CM does not list Includes notes for C00 in this effective period.

Excludes 1

Official
  • malignant melanoma of lip (C43.0)
  • Merkel cell carcinoma of lip (C4A.0)
  • other and unspecified malignant neoplasm of skin of lip (C44.0-)

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for C00 in this effective period.

Use Additional

Official
  • code to identify:
  • alcohol abuse and dependence (F10.-)
  • history of tobacco dependence (Z87.891)
  • tobacco dependence (F17.-)
  • tobacco use (Z72.0)

Code Also

Official

ICD-10-CM does not list Code Also instructions for C00 in this effective period.

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

What This Code Means

C00 is the ICD-10-CM diagnosis code for malignant neoplasm of lip. C00 sits in the ICD-10-CM chapter for neoplasms (c00-d49), within the section covering malignant neoplasms of lip, oral cavity and pharynx (c00-c14).

Header codes like C00 cannot be reported on claims directly, they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at C00's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for C00 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Excludes 1, Do NOT code together

  • malignant melanoma of lip (C43.0)
  • Merkel cell carcinoma of lip (C4A.0)
  • other and unspecified malignant neoplasm of skin of lip (C44.0-)

Use Additional Code

  • code to identify:
  • alcohol abuse and dependence (F10.-)
  • history of tobacco dependence (Z87.891)
  • tobacco dependence (F17.-)
  • tobacco use (Z72.0)

Child Codes

Code Hierarchy

C00Malignant neoplasm of lip
C00Malignant neoplasm of lip

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