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C38 ICD-10-CM Code: Malignant neoplasm of heart, mediastinum and pleura

C38 is not a CMS-HCC payment code. MEAT criteria · RAF calculator · HCC coding software

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

C38

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

Malignant neoplasm of heart, mediastinum and pleura

Malignant neoplasm of heart, mediastinum and pleura

CMS-HCC V28

N/A

Not mapped

CMS-HCC V24

N/A

Not mapped

ACA/HHS

N/A

Not mapped

ESRD/PACE

N/A

Not mapped

RXHCC

N/A

Not mapped

Code Book Path

Official
C3Malignant neoplasms of respiratory and intrathoracic organs (C30-C39)
C38Malignant neoplasm of heart, mediastinum and pleura

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for C38 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for C38 in this effective period.

Related Child Codes

Official
C38.0Malignant neoplasm of heart
C38.1Malignant neoplasm of anterior mediastinum
C38.2Malignant neoplasm of posterior mediastinum
C38.3Malignant neoplasm of mediastinum, part unspecified
C38.4Malignant neoplasm of pleura

Includes

Official

ICD-10-CM does not list Includes notes for C38 in this effective period.

Excludes 1

Official
  • mesothelioma (C45.-)

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for C38 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for C38 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for C38 in this effective period.

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 →

Code
C38
Description
Malignant neoplasm of heart, mediastinum and pleura
HCC (V28)
No CMS-HCC V28 mapping
RAF
Billable
No
Payment year
2026

Coder workflow notes

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What This Code Means

C38 is the ICD-10-CM diagnosis code for malignant neoplasm of heart, mediastinum and pleura. C38 sits in the ICD-10-CM chapter for neoplasms (c00-d49), within the section covering malignant neoplasms of respiratory and intrathoracic organs (c30-c39).

Header codes like C38 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 C38'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 C38 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Excludes 1, Do NOT code together

  • mesothelioma (C45.-)

Child Codes

Code Hierarchy

C38Malignant neoplasm of heart, mediastinum and pleura
C38Malignant neoplasm of heart, mediastinum and pleura

Work C38 in HCC Buddy

Open C38 in the Code Book for the full Index-to-Tabular path, MEAT checklist, and V28 HCC mapping, or in the Encoder to code from a keyword search. Pro includes 7 days to try everything, no card required.