C46.2 ICD-10-CM Code: Kaposi's sarcoma of palate
C46.2 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 · free HCC coding tools
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FY 2026 Apr update / Neoplasms (C00-D49) / Malignant neoplasms of mesothelial and soft tissue (C45-C49)
C46.2
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceKaposi's sarcoma of palate
A cancer of blood vessel cells occurring in the roof of the mouth (hard palate), presenting as a visible lesion in the oral cavity.
Buddy Insight
Kaposi sarcoma of the palate is a specific oral manifestation that is often the initial presenting sign of Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome.
CMS-HCC V28
MappedHCC 21
Coefficient HCC 21: 0.671 (Community Non-Dual Aged (CNA))
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
MappedHCC 010
Code-level coefficient reference
ESRD/PACE
MappedHCC 10
Code-level coefficient reference
RXHCC
MappedHCC 20
Code-level coefficient reference
Code Book Path
Inclusion Terms
OfficialNo inclusion terms are included in this display for C46.2. Check the code and parent instructions in the Code Book.
Excludes 2
OfficialNo Excludes 2 notes are included in this display for C46.2. Check the code and parent instructions in the Code Book.
Related Codes
Includes
OfficialNo Includes notes are included in this display for C46.2. Check the code and parent instructions in the Code Book.
Excludes 1
OfficialNo Excludes 1 notes are included in this display for C46.2. Check the code and parent instructions in the Code Book.
Code First
Official- any human immunodeficiency virus [HIV] disease (B20)Inherited from C46
Use Additional
OfficialNo Use Additional Code instructions are included in this display for C46.2. Check the code and parent instructions in the Code Book.
Code Also
OfficialNo Code Also instructions are included in this display for C46.2. Check the code and parent instructions in the Code Book.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
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 C46.2 an HCC code?
Yes. C46.2 (Kaposi's sarcoma of palate) 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: C46.2 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
- C46.2
- Description
- Kaposi's sarcoma of palate
- HCC (V28)
- HCC 21 — Lymphoma and Other Cancers
- RAF reference coefficient
- 0.671
- Billable
- Yes
- Payment year
- 2026
HCC Category Mapping
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 C46.2 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →
MEAT review for C46.2
For C46.2, 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
C46.2 is the ICD-10-CM diagnosis code for kaposi's sarcoma of palate. A cancer of blood vessel cells occurring in the roof of the mouth (hard palate), presenting as a visible lesion in the oral cavity. C46.2 sits in the ICD-10-CM chapter for neoplasms (c00-d49), within the section covering malignant neoplasms of mesothelial and soft tissue (c45-c49).
Under the CMS-HCC V28 risk adjustment model, C46.2 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 C46.2; 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.
Palatal involvement may affect speech, swallowing, or eating; document functional impact and any associated oral complications. For C46.2, 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 C46.2 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Palatal involvement may affect speech, swallowing, or eating; document functional impact and any associated oral complications
- •Confirm the lesion is in the palate specifically and not in other oral sites (tongue, gums, etc.) which would have different codes
Clinical Significance
Kaposi sarcoma of the palate is a specific oral manifestation that is often the initial presenting sign of Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome. The hard palate is the most common oral site for Kaposi sarcoma and its presence may indicate the need for initiation or optimization of antiretroviral therapy.
Documentation Requirements
- ✓Biopsy-confirmed diagnosis from the palatal lesion
- ✓Specification of hard palate versus soft palate involvement
- ✓Size, color, and morphology of the lesion
- ✓Human Immunodeficiency Virus status, CD4 count, and viral load
- ✓Impact on oral function (eating, speech, swallowing)
Commonly Confused Codes
- •C05.0/C05.1 (Malignant neoplasm of hard/soft palate): squamous cell carcinoma of palate, not Kaposi sarcoma
- •C46.0 (Kaposi sarcoma of skin): oral mucosa is not classified as skin; palate has its own code
- •C46.7 (Kaposi sarcoma of other sites): do not use for palate when C46.2 exists
- •D10.6 (Benign neoplasm of nasopharynx): benign and different anatomical location