C00.9 ICD-10-CM Code: Malignant neoplasm of lip, unspecified
C00.9 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · free HCC coding tools
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FY 2026 Apr update / Neoplasms (C00-D49) / Malignant neoplasms of lip, oral cavity and pharynx (C00-C14)
C00.9
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceMalignant neoplasm of lip, unspecified
Cancer of the lip where the specific location is not documented or identified.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialNo inclusion terms are included in this display for C00.9. Check the code and parent instructions in the Code Book.
Excludes 2
OfficialNo Excludes 2 notes are included in this display for C00.9. Check the code and parent instructions in the Code Book.
Related Codes
Includes
OfficialNo Includes notes are included in this display for C00.9. Check the code and parent instructions in the Code Book.
Excludes 1
Official- malignant melanoma of lip (C43.0)Inherited from C00
- Merkel cell carcinoma of lip (C4A.0)Inherited from C00
- other and unspecified malignant neoplasm of skin of lip (C44.0-)Inherited from C00
Code First
OfficialNo Code First sequencing instructions are included in this display for C00.9. Check the code and parent instructions in the Code Book.
Use Additional
Official- code to identify:Inherited from C00
- alcohol abuse and dependence (F10.-)Inherited from C00
- history of tobacco dependence (Z87.891)Inherited from C00
- tobacco dependence (F17.-)Inherited from C00
- tobacco use (Z72.0)Inherited from C00
Code Also
OfficialNo Code Also instructions are included in this display for C00.9. Check the code and parent instructions in the Code Book.
Buddy Documentation Tip
Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →
Is C00.9 an HCC code?
No. C00.9 is a billable ICD-10-CM code with no mapping under the current CMS-HCC V28 community payment model, and none under the ESRD, Part D RxHCC, or HHS-HCC models.
- Code
- C00.9
- Description
- Malignant neoplasm of lip, unspecified
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF reference coefficient
- —
- Billable
- Yes
- Payment year
- 2026
Coder workflow notes
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What This Code Means
C00.9 is the ICD-10-CM diagnosis code for malignant neoplasm of lip, unspecified. Cancer of the lip where the specific location is not documented or identified. C00.9 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).
C00.9 is a billable ICD-10-CM code, but no current CMS-HCC V28 community payment mapping is shown, and none under the ESRD, Part D RxHCC, or HHS-HCC models. Do not assign risk adjustment value from this page when no source-backed mapping is shown; verify the applicable model and payment year.
Request clarification from the provider about the specific site of the lip lesion (upper, lower, or commissure).
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for C00.9 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Request clarification from the provider about the specific site of the lip lesion (upper, lower, or commissure)
- •Review pathology reports to determine if a more specific lip location code should be used