C07
BillableMalignant neoplasm of parotid gland
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is C07 an HCC code?
Yes. C07 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 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.
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 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, C07 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.
Confirm laterality (left or right parotid) is documented for complete coding. Because C07 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 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