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C37 ICD-10-CM Code: Malignant neoplasm of thymus

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FY 2026 Apr update / Neoplasms (C00-D49) / Malignant neoplasms of respiratory and intrathoracic organs (C30-C39)

C37

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

Malignant neoplasm of thymus

Cancer that develops in the thymus, a small gland located behind the breastbone that is part of the immune system.

Buddy the Bee presenting code insight

Buddy Insight

Thymic cancer is rare, with thymomas being the most common type.

CMS-HCC V28

HCC 21

RAF 0.671

CMS-HCC V24

HCC 11

RAF 0.307

ACA/HHS

HCC 11

Varies by metal level

ESRD/PACE

HCC 11

RAF 0.059

RXHCC

HCC 22

RAF 0.124

Code Book Path

Official
C3Malignant neoplasms of respiratory and intrathoracic organs (C30-C39)
C37Malignant neoplasm of thymus

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for C37 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for C37 in this effective period.

Related Child Codes

Official

ICD-10-CM does not list child codes under C37 for this display context.

Includes

Official

ICD-10-CM does not list Includes notes for C37 in this effective period.

Excludes 1

Official
  • malignant carcinoid tumor of the thymus (C7A.091)

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for C37 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for C37 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for C37 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
Pathology confirmation distinguishing thymoma (types A, AB, B1, B2, B3) from thymic carcinoma
WHO histological classification and Masaoka-Koga staging
Assessment for paraneoplastic syndromes (myasthenia gravis, pure red cell aplasia, hypogammaglobulinemia)
Imaging showing thymic origin in the anterior mediastinum

MEAT Support

HCC Buddy guidance
Pathology confirmation distinguishing thymoma (types A, AB, B1, B2, B3) from thymic carcinoma
WHO histological classification and Masaoka-Koga staging
Assessment for paraneoplastic syndromes (myasthenia gravis, pure red cell aplasia, hypogammaglobulinemia)
Imaging showing thymic origin in the anterior mediastinum

Audit Caution

HCC Buddy guidance
Confusing thymus (C37) with thyroid (C73) — a common transcription error in documentation
Not distinguishing between thymoma and thymic carcinoma which have different prognoses
Coding anterior mediastinal mass as thymic cancer without pathological confirmation
Missing paraneoplastic syndrome codes (e.g., myasthenia gravis G70.00) that should be coded additionally

Common Mistakes

HCC Buddy guidance
C73 — Thyroid cancer: 'Thymus' and 'thyroid' are easily confused in documentation — verify anatomical site
C38.1 — Anterior mediastinum: Thymic tumors are in the anterior mediastinum; if documented as 'anterior mediastinal mass,' query for thymic origin
D15.0 — Benign neoplasm of thymus: Some thymomas are benign; confirm malignancy
C85.1 — Unspecified B-cell lymphoma: Mediastinal lymphomas may mimic thymic tumors

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.

Is C37 an HCC code?

Yes. C37 maps to Lymphoma and Other Cancers under the CMS-HCC V28 risk adjustment model (and Colorectal, Bladder, and Other Cancers under V24).

HCC Category Mapping

V28HCC 21, Lymphoma and Other Cancers
0.671
V24HCC 11, Colorectal, Bladder, and Other Cancers
0.307
ESRDHCC 11, Colorectal, Bladder, and Other Cancers
0.059
RxHCCHCC 22, Cancer, Other Specified Sites
0.124

Each model's RAF is its CMS base weight for that model's standard population, so 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 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.

Work C37 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for C37

For C37to 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 C37 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

C37 is the ICD-10-CM diagnosis code for malignant neoplasm of thymus. Cancer that develops in the thymus, a small gland located behind the breastbone that is part of the immune system. C37 sits in the ICD-10-CM chapter for neoplasms (c00-d49), within the section covering malignant neoplasms of respiratory and intrathoracic organs (c30-c39).

Under the CMS-HCC V28 risk adjustment model, C37 maps to Lymphoma and Other Cancers (HCC 21) with a community, non-dual, aged base RAF weight of 0.671. Under the older CMS-HCC V24 model, C37 maps to Colorectal, Bladder, and Other Cancers (HCC 11) with a community, non-dual, aged base RAF weight of 0.307. 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.

Thymic cancers are relatively rare; ensure documentation clearly indicates thymus as primary site. Because C37 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 C37 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Thymic cancers are relatively rare; ensure documentation clearly indicates thymus as primary site
  • Do not confuse with thyroid cancer (C73)

Clinical Significance

Thymic cancer is rare, with thymomas being the most common type. These tumors are significant in risk adjustment because they are often associated with paraneoplastic syndromes, most notably myasthenia gravis, which adds complexity to patient management. Thymic carcinomas are more aggressive than thymomas and carry a worse prognosis.

Documentation Requirements

  • Pathology confirmation distinguishing thymoma (types A, AB, B1, B2, B3) from thymic carcinoma
  • WHO histological classification and Masaoka-Koga staging
  • Assessment for paraneoplastic syndromes (myasthenia gravis, pure red cell aplasia, hypogammaglobulinemia)
  • Imaging showing thymic origin in the anterior mediastinum
  • Resection status (complete vs. incomplete)

Excludes 1, Do NOT code together

  • malignant carcinoid tumor of the thymus (C7A.091)

Commonly Confused Codes

  • C73: Thyroid cancer: 'Thymus' and 'thyroid' are easily confused in documentation: verify anatomical site
  • C38.1: Anterior mediastinum: Thymic tumors are in the anterior mediastinum; if documented as 'anterior mediastinal mass,' query for thymic origin
  • D15.0: Benign neoplasm of thymus: Some thymomas are benign; confirm malignancy
  • C85.1: Unspecified B-cell lymphoma: Mediastinal lymphomas may mimic thymic tumors

Code Hierarchy

C37Malignant neoplasm of thymus
C37Malignant neoplasm of thymus

Because C37 maps to a payment HCC, the documentation must also satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's risk adjustment score.

C37 maps to CMS-HCC V28 category 21, Lymphoma and Other Cancers. See the ICD-10 to HCC mapping hub for how the V28 crosswalk works.

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