C02.2
BillableMalignant neoplasm of ventral surface of tongue
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is C02.2 an HCC code?
Yes. C02.2 maps to Breast, Prostate, Colorectal and Other Cancers and Tumors under the CMS-HCC V28 risk adjustment model (and Colorectal, Bladder, and Other Cancers under V24).
HCC Category Mapping
RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.
MEAT Criteria for C02.2
For C02.2 to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically — it has to be re-documented and supported each calendar year.
- MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
- EEvaluate: test results, medication response, or physical findings reviewed by the provider
- AAssess: explicit mention in the assessment or plan with acknowledgment of status
- TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis
Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed C02.2 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
C02.2 is the ICD-10-CM diagnosis code for malignant neoplasm of ventral surface of tongue. Cancer of the underside of the tongue, the surface that faces the floor of the mouth. C02.2 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).
Under the CMS-HCC V28 risk adjustment model, C02.2 maps to Breast, Prostate, Colorectal and Other Cancers and Tumors (HCC 21) with a community, non-dual, aged base RAF weight of 0.545. Under the older CMS-HCC V24 model, C02.2 maps to Colorectal, Bladder, and Other Cancers (HCC 11) with a community, non-dual, aged base RAF weight of 0.306. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition.
Ventral surface is the bottom/underside of the tongue; confirm this location in provider documentation. Because C02.2 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for C02.2 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Ventral surface is the bottom/underside of the tongue; confirm this location in provider documentation
- •This is distinct from the dorsal (top) surface coded as C02.0
Clinical Significance
Malignant neoplasm of the ventral surface of the tongue affects the underside facing the floor of mouth. This location has a thinner mucosal lining and close proximity to major blood vessels and sublingual glands, facilitating early deep invasion and potential spread. Ventral surface cancers may also involve the floor of mouth, creating coding complexity regarding the primary site.
Documentation Requirements
- ✓Pathology confirming malignancy with histologic type
- ✓Documentation clearly specifying ventral (undersurface) of tongue as primary site
- ✓Distinction from floor of mouth involvement documented
- ✓Depth of invasion and tumor size documented
- ✓Staging (TNM oral cavity staging system)
- ✓Active disease status confirmed