C08.1 ICD-10-CM Code: Malignant neoplasm of sublingual gland
C08.1 maps to CMS-HCC V28 21. A source-labeled RAF reference is available. Confirm the documented diagnosis and applicable coding requirements. 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)
C08.1
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceMalignant neoplasm of sublingual gland
Cancer that starts in the sublingual gland, a small salivary gland located under the tongue.
Buddy Insight
Malignant neoplasm of the sublingual gland is a rare cancer of the smallest major salivary gland located beneath the tongue.
CMS-HCC V28
MappedHCC 21
Coefficient HCC 21: 0.671 (Community Non-Dual Aged (CNA))
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
MappedHCC 011
Code-level coefficient reference
ESRD/PACE
MappedHCC 11
Code-level coefficient reference
RXHCC
MappedHCC 22
Code-level coefficient reference
Code Book Path
Inclusion Terms
OfficialNo inclusion terms are included in this display for C08.1. Check the code and parent instructions in the Code Book.
Excludes 2
Official- malignant neoplasms of minor salivary glands NOS (C06.9)Inherited from C08
- malignant neoplasm of parotid gland (C07)Inherited from C08
Related Codes
Includes
Official- malignant neoplasm of salivary ductsInherited from C08
Excludes 1
Official- malignant neoplasms of specified minor salivary glands which are classified according to their anatomical locationInherited from C08
Code First
OfficialNo Code First sequencing instructions are included in this display for C08.1. Check the code and parent instructions in the Code Book.
Use Additional
Official- code to identify:Inherited from C08
- alcohol abuse and dependence (F10.-)Inherited from C08
- exposure to environmental tobacco smoke (Z77.22)Inherited from C08
- exposure to tobacco smoke in the perinatal period (P96.81)Inherited from C08
- history of tobacco dependence (Z87.891)Inherited from C08
- occupational exposure to environmental tobacco smoke (Z57.31)Inherited from C08
- tobacco dependence (F17.-)Inherited from C08
- tobacco use (Z72.0)Inherited from C08
Code Also
OfficialNo Code Also instructions are included in this display for C08.1. Check the code and parent instructions in the Code Book.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
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 C08.1 an HCC code?
Yes. C08.1 (Malignant neoplasm of sublingual 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: C08.1 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
- C08.1
- Description
- Malignant neoplasm of sublingual gland
- HCC (V28)
- HCC 21 — Lymphoma and Other Cancers
- RAF reference coefficient
- 0.671
- Billable
- Yes
- Payment year
- 2026
HCC Category Mapping
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 C08.1 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →
MEAT review for C08.1
For C08.1, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.
- 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
Coder workflow notes
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What This Code Means
C08.1 is the ICD-10-CM diagnosis code for malignant neoplasm of sublingual gland. Cancer that starts in the sublingual gland, a small salivary gland located under the tongue. C08.1 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, C08.1 maps to Lymphoma and Other Cancers (HCC 21) with a source-labeled community, non-dual, aged reference coefficient of 0.671. For CY2026 non-PACE Medicare Advantage, CMS uses 100% of the 2024 CMS-HCC model (V28). PACE uses a separate model blend. 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 sublingual location is documented to avoid confusion with submandibular gland. For C08.1, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule. 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 C08.1 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Confirm sublingual location is documented to avoid confusion with submandibular gland
- •Document any involvement of surrounding oral structures
Clinical Significance
Malignant neoplasm of the sublingual gland is a rare cancer of the smallest major salivary gland located beneath the tongue. Sublingual gland malignancies have a high proportion of adenoid cystic carcinomas, which are characterized by perineural invasion and a tendency for late recurrence, requiring long-term surveillance.
Documentation Requirements
- ✓Pathology-confirmed malignancy with histological subtype (adenoid cystic carcinoma common)
- ✓Documentation specifically identifying sublingual gland as primary site
- ✓Assessment of perineural invasion and extension to floor of mouth
- ✓Laterality (right or left)
- ✓Long-term surveillance plan given high late recurrence risk
Commonly Confused Codes
- •C08.0: Malignant neoplasm of submandibular gland; the sublingual gland is smaller and located beneath the tongue, not under the jaw
- •C04.1: Lateral floor of mouth; sublingual gland tumors may present as floor of mouth masses
- •C08.9: Major salivary gland, unspecified; avoid when sublingual gland is documented
- •D11.7: Benign neoplasm of other major salivary glands; distinguish benign from malignant