C21
Non-Billable (Header)Malignant neoplasm of anus and anal canal
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
What This Code Means
C21 is the ICD-10-CM diagnosis code for malignant neoplasm of anus and anal canal. C21 sits in the ICD-10-CM chapter for neoplasms (c00-d49), within the section covering malignant neoplasms of digestive organs (c15-c26).
Header codes like C21 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 C21'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 C21 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Excludes 2 — Not included here, may code separately
- malignant carcinoid tumors of the colon (C7A.02-)
- malignant melanoma of anal margin (C43.51)
- malignant melanoma of anal skin (C43.51)
- malignant melanoma of perianal skin (C43.51)
- other and unspecified malignant neoplasm of anal margin (C44.500, C44.510, C44.520, C44.590)
- other and unspecified malignant neoplasm of anal skin (C44.500, C44.510, C44.520, C44.590)
- other and unspecified malignant neoplasm of perianal skin (C44.500, C44.510, C44.520, C44.590)