C47.3
BillableMalignant neoplasm of peripheral nerves of thorax
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is C47.3 an HCC code?
Yes. C47.3 maps to Breast, Prostate, Colorectal and Other Cancers and Tumors under the CMS-HCC V28 risk adjustment model (and Lymphoma and Other Cancers under V24).
HCC Category Mapping
RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. 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.
MEAT Criteria for C47.3
For C47.3 to 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 C47.3 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
C47.3 is the ICD-10-CM diagnosis code for malignant neoplasm of peripheral nerves of thorax. Cancer that develops in the nerves of the chest wall and thoracic cavity. This malignant tumor affects peripheral nerve tissue in the thorax region. C47.3 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, C47.3 maps to Breast, Prostate, Colorectal and Other Cancers and Tumors (HCC 21) with a community, non-dual, aged base RAF weight of 0.545. Under the older CMS-HCC V24 model, C47.3 maps to Lymphoma and Other Cancers (HCC 10) with a community, non-dual, aged base RAF weight of 0.675. 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.
Thorax includes chest wall nerves; do not confuse with lung cancer (C34) or mediastinal tumors. Because C47.3 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 C47.3 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Thorax includes chest wall nerves; do not confuse with lung cancer (C34) or mediastinal tumors
- •Document specific anatomical location within thorax if available for more precise coding
Clinical Significance
Malignant neoplasm of peripheral nerves of the thorax includes tumors arising from intercostal nerves and other chest wall peripheral nerves. These rare sarcomas can be difficult to distinguish from mediastinal tumors or chest wall soft tissue sarcomas and require careful pathological classification.
Documentation Requirements
- ✓Pathology confirming nerve sheath origin within the thorax
- ✓Specific location within the thorax (chest wall, intercostal, paravertebral, etc.)
- ✓Imaging (MRI or CT) demonstrating tumor extent and relationship to thoracic structures
- ✓Distinction from mediastinal tumors, lung tumors, or chest wall soft tissue sarcomas
- ✓Surgical margins and completeness of resection if applicable
Commonly Confused Codes
- •C49.3 (Malignant neoplasm of connective/soft tissue of thorax) — soft tissue tumor of chest wall, not nerve origin
- •C34._ (Malignant neoplasm of bronchus and lung) — lung parenchymal cancer, not nerve tumor
- •C38._ (Malignant neoplasm of heart, mediastinum, and pleura) — mediastinal tumors have different codes
- •C47.6 (Peripheral nerves of trunk, unspecified) — use C47.3 when thorax is specified