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C11 ICD-10-CM Code: Malignant neoplasm of nasopharynx

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

C11

Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidance

Malignant neoplasm of nasopharynx

Malignant neoplasm of nasopharynx

CMS-HCC V28

0

0

RAF 0

CMS-HCC V24

0

0

RAF 0

ACA/HHS

0

0

RAF 0

ESRD/PACE

0

0

RAF 0

RXHCC

0

0

RAF 0

Code Trumping

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Code Book Path

Official
C1Malignant neoplasms of lip, oral cavity and pharynx (C00-C14)
C11Malignant neoplasm of nasopharynx

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for C11 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for C11 in this effective period.

Related Child Codes

Official
C11.0Malignant neoplasm of superior wall of nasopharynx
C11.1Malignant neoplasm of posterior wall of nasopharynx
C11.2Malignant neoplasm of lateral wall of nasopharynx
C11.3Malignant neoplasm of anterior wall of nasopharynx
C11.8Malignant neoplasm of overlapping sites of nasopharynx

Includes

Official

ICD-10-CM does not list Includes notes for C11 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for C11 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for C11 in this effective period.

Use Additional

Official
  • code to identify:
  • 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)

Code Also

Official

ICD-10-CM does not list Code Also instructions for C11 in this effective period.

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

What This Code Means

C11 is the ICD-10-CM diagnosis code for malignant neoplasm of nasopharynx. C11 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).

Header codes like C11 cannot be reported on claims directly, they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at C11's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for C11 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Use Additional Code

  • code to identify:
  • 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)

Child Codes

Code Hierarchy

C11Malignant neoplasm of nasopharynx
C11Malignant neoplasm of nasopharynx

More on C11

Referenced in blog posts

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