What is ICD-10 code C13.0?

C13.0 is the ICD-10-CM diagnosis code for Malignant neoplasm of postcricoid region. Cancer in the postcricoid region, the area of the throat just below the voice box behind the cricoid cartilage. It belongs to the ICD-10-CM chapter for neoplasms (c00-d49). C13.0 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. C13.0 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. C13.0 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. C13.0 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 C13.0 map to under V28?

C13.0 maps to CMS-HCC V28 HCC 21 (Lymphoma and Other Cancers). The category numbers, labels, and conditions come from the CMS-HCC V28 model file for payment year 2026.

2026 ICD-10-CM C13.0: Malignant neoplasm

C13.0 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 · HCC Buddy coding tools

ICD-10-CM Code View

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Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.

Code lookupC13.0

Effective periodFY2026 Apr Update (Apr 1-Sep 30)

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

C13.0

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

Malignant neoplasm of postcricoid region

Cancer in the postcricoid region, the area of the throat just below the voice box behind the cricoid cartilage.

Buddy Insight

Malignant neoplasm of the postcricoid region is a hypopharyngeal cancer arising behind the cricoid cartilage at the entrance to the esophagus.

Overview Risk Models Code Book Documentation Audit Notes Edition comparison

CMS-HCC V28

Mapped

HCC 21

Lymphoma and Other Cancers

Code-level coefficient reference

CMS-HCC V24

Historical

Not used for standard CY2026 Medicare Advantage payment. Select a historical period to review V24.

Not used for CY2026 payment

ACA/HHS

Mapped

HCC 011

HHS-HCC 011 adult, RAF varies...

Code-level coefficient reference

ESRD/PACE

Mapped

HCC 11

Colorectal/Bladder/and Other ...

Code-level coefficient reference

RXHCC

N/A

—

Not risk-adjusted for this model/period.

Not mapped

Code Book Path

Official

C13Malignant neoplasm of hypopharynx C13.0Malignant neoplasm of postcricoid region

Inclusion Terms

Official

No inclusion terms are included in this display for C13.0. Check the code and parent instructions in the Code Book.

Excludes 2

Official

malignant neoplasm of pyriform sinus (C12)Inherited from C13

Related Codes

Official

C13.1Malignant neoplasm of aryepiglottic fold, hypopharyngeal aspect C13.2Malignant neoplasm of posterior wall of hypopharynx C13.8Malignant neoplasm of overlapping sites of hypopharynx C13.9Malignant neoplasm of hypopharynx, unspecified

Includes

Official

No Includes notes are included in this display for C13.0. Check the code and parent instructions in the Code Book.

Excludes 1

Official

No Excludes 1 notes are included in this display for C13.0. Check the code and parent instructions in the Code Book.

Code First

Official

No Code First sequencing instructions are included in this display for C13.0. Check the code and parent instructions in the Code Book.

Use Additional

Official

code to identify:Inherited from C13
exposure to environmental tobacco smoke (Z77.22)Inherited from C13
exposure to tobacco smoke in the perinatal period (P96.81)Inherited from C13
history of tobacco dependence (Z87.891)Inherited from C13
occupational exposure to environmental tobacco smoke (Z57.31)Inherited from C13
tobacco dependence (F17.-)Inherited from C13
tobacco use (Z72.0)Inherited from C13

Code Also

Official

No Code Also instructions are included in this display for C13.0. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance

Pathology-confirmed malignancy with histological type

Documentation specifying postcricoid region as primary site

Assessment of esophageal extension and cervical esophageal involvement

Evaluation of iron deficiency and Plummer-Vinson syndrome history

MEAT Support

HCC Buddy guidance

Pathology-confirmed malignancy with histological type

Documentation specifying postcricoid region as primary site

Assessment of esophageal extension and cervical esophageal involvement

Evaluation of iron deficiency and Plummer-Vinson syndrome history

Audit Caution

HCC Buddy guidance

Confusing postcricoid hypopharyngeal cancer with cervical esophageal cancer (C15.3) — the postcricoid area is above the esophageal inlet

Using pyriform sinus code (C12) for postcricoid tumors — these are different hypopharyngeal subsites

Not assessing for iron deficiency anemia or Plummer-Vinson syndrome which is associated with this location

Missing esophageal extension which may change the code to C14.8 (overlapping sites)

Common Mistakes

HCC Buddy guidance

C12 — Pyriform sinus; the pyriform sinus is lateral, the postcricoid area is posterior/midline

C15.3 — Upper third of esophagus; postcricoid tumors may extend inferiorly into the cervical esophagus

C32.3 — Laryngeal cartilage; postcricoid tumors may invade the cricoid cartilage posteriorly

C13.9 — Hypopharynx, unspecified; avoid when postcricoid is specifically documented

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 C13.0 an HCC code?

Yes. C13.0 (Malignant neoplasm of postcricoid region) 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: C13.0 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: C13.0
Description: Malignant neoplasm of postcricoid region
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

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 C13.0 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for C13.0

For C13.0, 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

C13.0 is the ICD-10-CM diagnosis code for malignant neoplasm of postcricoid region. Cancer in the postcricoid region, the area of the throat just below the voice box behind the cricoid cartilage. C13.0 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, C13.0 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 C13.0; use the applicable model and payment year when reviewing the V28 mapping. 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.

The postcricoid region is part of the hypopharynx; ensure distinction from laryngeal cancers. For C13.0, 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 C13.0 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•The postcricoid region is part of the hypopharynx; ensure distinction from laryngeal cancers
•This location is associated with Plummer-Vinson syndrome in some cases

Clinical Significance

Malignant neoplasm of the postcricoid region is a hypopharyngeal cancer arising behind the cricoid cartilage at the entrance to the esophagus. Postcricoid cancers have unique epidemiology, historically associated with Plummer-Vinson/Paterson-Kelly syndrome (iron deficiency anemia with esophageal webs) and are more common in women than other hypopharyngeal cancers.

Documentation Requirements

✓Pathology-confirmed malignancy with histological type
✓Documentation specifying postcricoid region as primary site
✓Assessment of esophageal extension and cervical esophageal involvement
✓Evaluation of iron deficiency and Plummer-Vinson syndrome history
✓TNM staging with laryngeal and esophageal invasion assessment

Commonly Confused Codes

•C12: Pyriform sinus; the pyriform sinus is lateral, the postcricoid area is posterior/midline
•C15.3: Upper third of esophagus; postcricoid tumors may extend inferiorly into the cervical esophagus
•C32.3: Laryngeal cartilage; postcricoid tumors may invade the cricoid cartilage posteriorly
•C13.9: Hypopharynx, unspecified; avoid when postcricoid is specifically documented