What is ICD-10 code C05.2?

C05.2 is the ICD-10-CM diagnosis code for Malignant neoplasm of uvula. Cancer that develops in the uvula, the small tissue projection hanging from the back of the soft palate. It belongs to the ICD-10-CM chapter for neoplasms (c00-d49). C05.2 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. C05.2 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. C05.2 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. C05.2 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

Which HCC does C05.2 map to under V28?

C05.2 maps to CMS-HCC V28 21 (Lymphoma and Other Cancers). The category number and label come from the CMS-HCC V28 model file for payment year 2026.

What does C05.2 pay in RAF?

C05.2 carries a community, non-dual, aged (CNA) RAF weight of 0.671 under CMS-HCC V28 for payment year 2026. The weight comes from the CMS V28 relative-factor file, not a hand-typed table.

What is the V28 vs V24 difference for C05.2?

CMS phased in the V28 risk adjustment model over payment years 2024 (33%), 2025 (67%), and 2026 (100%), replacing V24. V28 consolidates HCC categories, removes some lower-acuity conditions, and recalibrates RAF weights across the entire model. For C05.2, V28 maps to Lymphoma and Other Cancers at RAF 0.671 while V24 mapped to Colorectal, Bladder, and Other Cancers at RAF 0.307. Both models can still appear in legacy data and in payer-specific lookback periods.

2026 ICD-10-CM C05.2: Malignant neoplasm

C05.2 maps to CMS-HCC V28 21 (RAF 0.671). Documentation must support MEAT. MEAT criteria · RAF calculator · HCC Buddy coding tools

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Code lookupC05.2Effective periodFY2026 Apr Update (Apr 1-Sep 30)

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

C05.2

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Malignant neoplasm of uvula

Cancer that develops in the uvula, the small tissue projection hanging from the back of the soft palate.

Buddy Insight

Malignant neoplasm of the uvula is a rare oral cancer affecting the small pendulous tissue at the posterior edge of the soft palate.

CMS-HCC V28

Mapped

HCC 21

Lymphoma and Other Cancers

RAF 0.671

CMS-HCC V24

Mapped

HCC 11

Colorectal, Bladder, and Othe...

RAF 0.307

ACA/HHS

Mapped

HCC 11

HHS-HCC 11

Varies by metal level

ESRD/PACE

Mapped

HCC 11

Colorectal, Bladder, and Othe...

RAF 0.059

RXHCC

Mapped

HCC 22

Cancer, Other Specified Sites

RAF 0.124

Code Book Path

Official

C05Malignant neoplasm of palate

C05.2Malignant neoplasm of uvula

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for C05.2 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for C05.2 in this effective period.

Related Child Codes

Official

C05.0Malignant neoplasm of hard palate

C05.1Malignant neoplasm of soft palate

C05.8Malignant neoplasm of overlapping sites of palate

C05.9Malignant neoplasm of palate, unspecified

Includes

Official

ICD-10-CM does not list Includes notes for C05.2 in this effective period.

Excludes 1

Official

Kaposi's sarcoma of palate (C46.2)

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for C05.2 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 C05.2 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Pathology-confirmed malignancy with biopsy from uvula tissue

Documentation clearly identifying uvula as the primary site

Assessment of extension to soft palate and oropharyngeal structures

TNM staging including depth of invasion

MEAT Support

HCC Buddy guidance

Pathology-confirmed malignancy with biopsy from uvula tissue

Documentation clearly identifying uvula as the primary site

Assessment of extension to soft palate and oropharyngeal structures

TNM staging including depth of invasion

Audit Caution

HCC Buddy guidance

Assigning uvula code when the tumor actually originates in the soft palate and merely extends to the uvula

Not using C05.8 overlapping sites when the cancer clearly spans both uvula and soft palate

Confusing benign uvular enlargement or papillomas with malignancy

Failing to verify pathology confirmation given the rarity of primary uvular malignancy

Common Mistakes

HCC Buddy guidance

C05.1 — Malignant neoplasm of soft palate; the uvula is anatomically connected to the soft palate, and origin may be difficult to distinguish

C05.8 — Overlapping sites of palate; use when tumor involves both uvula and soft palate

C10.9 — Oropharynx, unspecified; uvular tumors may be misclassified as oropharyngeal cancers

C09.0 — Tonsillar fossa; adjacent site that may be confused with uvular origin

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 C05.2 an HCC code?

Yes. C05.2 (Malignant neoplasm of uvula) maps to Lymphoma and Other Cancers under the CMS-HCC V28 risk adjustment model (and Colorectal, Bladder, and Other Cancers under V24), with a community non-dual aged RAF of 0.671. It is billable for payment year 2026.

Coder answer: C05.2 is billable and maps to V28 HCC 21, Lymphoma and Other Cancers. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code: C05.2
Description: Malignant neoplasm of uvula
HCC (V28): HCC 21 — Lymphoma and Other Cancers
RAF: 0.671
Billable: Yes
Payment year: 2026

HCC Category Mapping

V28HCC 21, Lymphoma and Other Cancers

0.671

V24HCC 11, Colorectal, Bladder, and Other Cancers

0.307

ESRDHCC 11, Colorectal, Bladder, and Other Cancers

0.059

RxHCCHCC 22, Cancer, Other Specified Sites

0.124

Each model's RAF is its CMS base weight for that model's standard population, so weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. 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.

Work C05.2 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for C05.2

For C05.2 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 C05.2 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

C05.2 is the ICD-10-CM diagnosis code for malignant neoplasm of uvula. Cancer that develops in the uvula, the small tissue projection hanging from the back of the soft palate. C05.2 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, C05.2 maps to Lymphoma and Other Cancers (HCC 21) with a community, non-dual, aged base RAF weight of 0.671. Under the older CMS-HCC V24 model, C05.2 maps to Colorectal, Bladder, and Other Cancers (HCC 11) with a community, non-dual, aged base RAF weight of 0.307. 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.

Uvula cancers are relatively rare; verify documentation carefully. Because C05.2 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 C05.2 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Uvula cancers are relatively rare; verify documentation carefully
•Note any extension to soft palate or pharynx if present

Clinical Significance

Malignant neoplasm of the uvula is a rare oral cancer affecting the small pendulous tissue at the posterior edge of the soft palate. Its rarity makes accurate documentation essential, and because the uvula is small, cancers here almost always extend to the soft palate or oropharynx, requiring careful assessment of true origin site.

Documentation Requirements

✓Pathology-confirmed malignancy with biopsy from uvula tissue
✓Documentation clearly identifying uvula as the primary site
✓Assessment of extension to soft palate and oropharyngeal structures
✓TNM staging including depth of invasion
✓Provider confirmation that the primary origin is uvula rather than adjacent soft palate or oropharynx

Commonly Confused Codes

•C05.1: Malignant neoplasm of soft palate; the uvula is anatomically connected to the soft palate, and origin may be difficult to distinguish
•C05.8: Overlapping sites of palate; use when tumor involves both uvula and soft palate
•C10.9: Oropharynx, unspecified; uvular tumors may be misclassified as oropharyngeal cancers
•C09.0: Tonsillar fossa; adjacent site that may be confused with uvular origin