C47.5 ICD-10-CM Code: Malignant neoplasm of peripheral nerves of pelvis
C47.5 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 · HCC Buddy coding tools
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FY 2026 Apr update / Neoplasms (C00-D49) / Malignant neoplasms of mesothelial and soft tissue (C45-C49)
C47.5
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceMalignant neoplasm of peripheral nerves of pelvis
Cancer that develops in the nerves of the pelvic region. This malignant tumor affects peripheral nerve tissue in the pelvis.
Buddy Insight
Malignant neoplasm of peripheral nerves of the pelvis involves tumors arising from pelvic plexus or sacral nerve roots in the peripheral distribution.
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 22
Code-level coefficient reference
Code Book Path
Inclusion Terms
OfficialNo inclusion terms are included in this display for C47.5. Check the code and parent instructions in the Code Book.
Excludes 2
OfficialNo Excludes 2 notes are included in this display for C47.5. Check the code and parent instructions in the Code Book.
Related Codes
Includes
Official- malignant neoplasm of sympathetic and parasympathetic nerves and gangliaInherited from C47
Excludes 1
Official- Kaposi's sarcoma of soft tissue (C46.1)Inherited from C47
Code First
OfficialNo Code First sequencing instructions are included in this display for C47.5. Check the code and parent instructions in the Code Book.
Use Additional
OfficialNo Use Additional Code instructions are included in this display for C47.5. Check the code and parent instructions in the Code Book.
Code Also
OfficialNo Code Also instructions are included in this display for C47.5. 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 C47.5 an HCC code?
Yes. C47.5 (Malignant neoplasm of peripheral nerves of pelvis) 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: C47.5 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
- C47.5
- Description
- Malignant neoplasm of peripheral nerves of pelvis
- 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 C47.5 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →
MEAT review for C47.5
For C47.5, 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
C47.5 is the ICD-10-CM diagnosis code for malignant neoplasm of peripheral nerves of pelvis. Cancer that develops in the nerves of the pelvic region. This malignant tumor affects peripheral nerve tissue in the pelvis. C47.5 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, C47.5 maps to Lymphoma and Other Cancers (HCC 21) with a source-labeled community, non-dual, aged reference coefficient of 0.671. 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.
Pelvis includes pelvic sidewall and pelvic floor nerves; distinguish from primary pelvic organ cancers. For C47.5, 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 C47.5 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Pelvis includes pelvic sidewall and pelvic floor nerves; distinguish from primary pelvic organ cancers
- •Verify documentation specifies peripheral nerve origin rather than other pelvic structures
Clinical Significance
Malignant neoplasm of peripheral nerves of the pelvis involves tumors arising from pelvic plexus or sacral nerve roots in the peripheral distribution. These deeply seated tumors are challenging to resect completely and frequently involve critical neurovascular structures, leading to significant postoperative morbidity.
Documentation Requirements
- ✓Pathology confirming malignant peripheral nerve tumor in the pelvic region
- ✓Specific nerve or plexus involved (sacral plexus, obturator nerve, etc.)
- ✓MRI pelvis showing tumor extent and relationship to pelvic organs
- ✓Functional impact (bladder, bowel, sexual function, lower extremity neurological status)
- ✓Distinction from primary pelvic organ malignancies
Commonly Confused Codes
- •C49.5 (Malignant neoplasm of connective/soft tissue of pelvis): soft tissue pelvic sarcoma, not nerve origin
- •C47.4 (Peripheral nerves of abdomen): different anatomical region above the pelvic brim
- •C47.6 (Peripheral nerves of trunk, unspecified): use C47.5 when pelvis is documented
- •C76.3 (Malignant neoplasm of pelvis): ill-defined pelvic site malignancy, not nerve-specific