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C07 ICD-10-CM Code: Malignant neoplasm of parotid gland

C07 maps to CMS-HCC V28 21. A source-labeled RAF reference is available. Documentation must support MEAT. MEAT criteria · RAF Calculator · HCC Buddy coding tools

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

C07

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

Malignant neoplasm of parotid gland

Cancer that starts in the parotid gland, which is the largest salivary gland located in front of and below the ear.

Buddy the Bee presenting code insight

Buddy Insight

Malignant neoplasm of the parotid gland is the most common major salivary gland cancer, accounting for approximately 80% of salivary gland malignancies.

CMS-HCC V28

HCC 21

Code-level coefficient reference

CMS-HCC V24

Historical

Historical

Not used for CY2026 payment

ACA/HHS

HCC 011

Code-level coefficient reference

ESRD/PACE

HCC 11

Code-level coefficient reference

RXHCC

HCC 22

Code-level coefficient reference

Code Book Path

Official
C0Malignant neoplasms of lip, oral cavity and pharynx (C00-C14)
C07Malignant neoplasm of parotid gland

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for C07 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for C07 in this effective period.

Related Child Codes

Official

ICD-10-CM does not list child codes under C07 for this display context.

Includes

Official

ICD-10-CM does not list Includes notes for C07 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for C07 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for C07 in this effective period.

Use Additional

Official
  • code to identify:
  • alcohol abuse and dependence (F10.-)
  • exposure to environmental tobacco smoke (Z77.22)
  • exposure to tobacco smoke in the perinatal period (P96.81)
  • history of tobacco dependence (Z87.891)

Code Also

Official

ICD-10-CM does not list Code Also instructions for C07 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
Pathology-confirmed malignancy with specific histological subtype (mucoepidermoid, adenoid cystic, acinic cell, etc.)
Laterality documented (right or left parotid gland)
Relationship to facial nerve (superficial vs deep lobe involvement)
TNM staging with particular attention to perineural invasion and nodal status

MEAT Support

HCC Buddy guidance
Pathology-confirmed malignancy with specific histological subtype (mucoepidermoid, adenoid cystic, acinic cell, etc.)
Laterality documented (right or left parotid gland)
Relationship to facial nerve (superficial vs deep lobe involvement)
TNM staging with particular attention to perineural invasion and nodal status

Audit Caution

HCC Buddy guidance
Confusing benign parotid tumors (D11.0, such as pleomorphic adenoma or Warthin's tumor) with malignant parotid neoplasms
Not documenting laterality which is always identifiable for parotid gland tumors
Coding metastatic cancer to parotid lymph nodes as primary parotid cancer — intraparotid lymph node metastases use secondary neoplasm codes
Missing the histological subtype which significantly impacts prognosis and treatment approach

Common Mistakes

HCC Buddy guidance
C08.0 — Malignant neoplasm of submandibular gland; the submandibular gland is below the jaw, while the parotid is in front of/below the ear
C08.9 — Major salivary gland, unspecified; avoid when parotid is specifically documented
D11.0 — Benign neoplasm of parotid gland; critical distinction between benign and malignant parotid tumors (pleomorphic adenoma is benign)
C77.0 — Secondary malignant neoplasm of lymph nodes of head; intraparotid lymph node metastasis should be coded differently

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 C07 an HCC code?

Yes. C07 (Malignant neoplasm of parotid gland) maps to HCC 21, Lymphoma and Other Cancers under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 0.671. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes. It is billable for payment year 2026.

Coder answer: C07 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
C07
Description
Malignant neoplasm of parotid gland
HCC (V28)
HCC 21 — Lymphoma and Other Cancers
RAF reference coefficient
0.671
Billable
Yes
Payment year
2026

HCC Category Mapping

V28HCC 21, Lymphoma and Other Cancers
0.671
ESRDHCC 11, Colorectal/Bladder/and Other Cancers
Not separately weighted
RxHCCHCC 22, Prostate, Breast, Bladder, and Other Cancers and Tumors
Not separately weighted

These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. 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 context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.

Work C07 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT Criteria for C07

For C07 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 C07 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

C07 is the ICD-10-CM diagnosis code for malignant neoplasm of parotid gland. Cancer that starts in the parotid gland, which is the largest salivary gland located in front of and below the ear. C07 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, C07 maps to Lymphoma and Other Cancers (HCC 21) with a source-labeled community, non-dual, aged reference coefficient of 0.671. No V24 mapping is shown for C07; use the applicable model and payment year when reviewing the V28 mapping. 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. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes.

Confirm laterality (left or right parotid) is documented for complete coding. Because C07 maps to an HCC category, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) before the diagnosis is used for risk adjustment. 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, source-labeled coefficient references, and MEAT documentation criteria for C07 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • •Confirm laterality (left or right parotid) is documented for complete coding
  • •Note that parotid gland cancers may require additional codes for metastases or complications

Clinical Significance

Malignant neoplasm of the parotid gland is the most common major salivary gland cancer, accounting for approximately 80% of salivary gland malignancies. The parotid gland's intimate relationship with the facial nerve makes surgical treatment complex, and the wide variety of histological subtypes affects prognosis and treatment planning significantly.

Documentation Requirements

  • ✓Pathology-confirmed malignancy with specific histological subtype (mucoepidermoid, adenoid cystic, acinic cell, etc.)
  • ✓Laterality documented (right or left parotid gland)
  • ✓Relationship to facial nerve (superficial vs deep lobe involvement)
  • ✓TNM staging with particular attention to perineural invasion and nodal status
  • ✓Grade of tumor (low, intermediate, or high grade)

Use Additional Code

  • code to identify:
  • alcohol abuse and dependence (F10.-)
  • exposure to environmental tobacco smoke (Z77.22)
  • exposure to tobacco smoke in the perinatal period (P96.81)
  • history of tobacco dependence (Z87.891)
  • occupational exposure to environmental tobacco smoke (Z57.31)
  • tobacco dependence (F17.-)
  • tobacco use (Z72.0)

Commonly Confused Codes

  • •C08.0: Malignant neoplasm of submandibular gland; the submandibular gland is below the jaw, while the parotid is in front of/below the ear
  • •C08.9: Major salivary gland, unspecified; avoid when parotid is specifically documented
  • •D11.0: Benign neoplasm of parotid gland; critical distinction between benign and malignant parotid tumors (pleomorphic adenoma is benign)
  • •C77.0: Secondary malignant neoplasm of lymph nodes of head; intraparotid lymph node metastasis should be coded differently

Code Hierarchy

└C07Malignant neoplasm of parotid gland
└C07Malignant neoplasm of parotid gland

Because C07 maps to an HCC category, the documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) before the diagnosis is used for risk adjustment.

C07 maps to CMS-HCC V28 category 21, Lymphoma and Other Cancers. See the ICD-10 to HCC mapping hub for how the V28 crosswalk works. The mapping identifies a payment HCC category for C07. Review its source-labeled HCC coefficient above, check the RAF Calculator with complete member context for CMS-HCC V28 PY2026, and confirm the documentation the chart needs before the code is submitted. HCC Buddy shows no RAF score unless every required source and calculation check passes.

Work C07 in HCC Buddy

Open C07 in the Code Book for the full Index-to-Tabular path, MEAT checklist, and V28 HCC mapping, or in the Encoder to code from a keyword search. Pro includes 7 days to try everything, no card required.

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