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C52 ICD-10-CM Code: Malignant neoplasm of vagina

C52 maps to CMS-HCC V28 22. A source-labeled RAF reference is available. Confirm the documented diagnosis and applicable coding requirements. MEAT criteria · RAF Calculator · HCC Buddy coding tools

ICD-10-CM Code View

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Code lookupC52

FY 2026 Apr update / Neoplasms (C00-D49) / Malignant neoplasms of female genital organs (C51-C58)

C52

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

Malignant neoplasm of vagina

Cancer that starts in the vagina, the muscular tube connecting the uterus to the external genitalia.

Buddy the Bee presenting code insight

Buddy Insight

Primary vaginal cancer is rare, accounting for only 1-2% of gynecological malignancies.

OverviewRisk ModelsCode BookDocumentationAuditNotesEdition comparison

CMS-HCC V28

HCC 22

Coefficient HCC 22: 0.363 (Community Non-Dual Aged (CNA))

CMS-HCC V24

Historical

Historical

Not used for CY2026 payment

ACA/HHS

HCC 012

Code-level coefficient reference

ESRD/PACE

HCC 11

Code-level coefficient reference

RXHCC

N/A

—

Not mapped

Code Book Path

Official
C5Malignant neoplasms of female genital organs (C51-C58)C52Malignant neoplasm of vagina

Inclusion Terms

Official

No inclusion terms are included in this display for C52. Check the code and parent instructions in the Code Book.

Excludes 2

Official

No Excludes 2 notes are included in this display for C52. Check the code and parent instructions in the Code Book.

Related Codes

Official

No related codes are included in this display for C52. Check the Code Book for the complete code path.

Includes

Official
  • malignant neoplasm of skin of female genital organsInherited from C51-C58

Excludes 1

Official
  • carcinoma in situ of vagina (D07.2)

Code First

Official

No Code First sequencing instructions are included in this display for C52. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for C52. Check the code and parent instructions in the Code Book.

Code Also

Official

No Code Also instructions are included in this display for C52. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance
Confirmation of primary vaginal malignancy (not metastatic from another site)
Histological type (squamous cell carcinoma, adenocarcinoma, melanoma, sarcoma)
Tumor location within the vagina (upper, middle, lower third) for staging
FIGO staging

MEAT Support

HCC Buddy guidance
Confirmation of primary vaginal malignancy (not metastatic from another site)
Histological type (squamous cell carcinoma, adenocarcinoma, melanoma, sarcoma)
Tumor location within the vagina (upper, middle, lower third) for staging
FIGO staging

Audit Caution

HCC Buddy guidance
Coding a metastatic vaginal deposit as primary vaginal cancer — most vaginal malignancies are secondary
Confusing cervical cancer with vaginal involvement versus primary vaginal cancer — coding guidelines specify that cervical cancer extending into the vagina is coded as cervical primary
Not verifying whether the patient had a prior hysterectomy, which impacts whether a vaginal cuff tumor is primary or recurrent cervical cancer
Failing to distinguish between in situ and invasive disease

Common Mistakes

HCC Buddy guidance
C53.9 — Malignant neoplasm of cervix uteri; cervical cancer extending into the vagina should be coded as cervical primary, not vaginal primary
C51.9 — Malignant neoplasm of vulva; lower vaginal tumors may extend to the vulva — determine primary site
C79.82 — Secondary malignant neoplasm of genital organs; use when vaginal involvement is metastatic from another primary
D07.2 — Carcinoma in situ of vagina; preinvasive disease, not invasive malignancy

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 C52 an HCC code?

Yes. C52 (Malignant neoplasm of vagina) maps to HCC 22, Bladder, Colorectal, and Other Cancers under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 0.363. 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: C52 is billable and maps to V28 HCC 22, Bladder, Colorectal, and Other Cancers. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code
C52
Description
Malignant neoplasm of vagina
HCC (V28)
HCC 22 — Bladder, Colorectal, and Other Cancers
RAF reference coefficient
0.363
Billable
Yes
Payment year
2026

HCC Category Mapping

V28HCC 22, Bladder, Colorectal, and Other Cancers
0.363
ESRDHCC 11, Colorectal/Bladder/and Other Cancers
Not separately weighted

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 C52 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for C52

For C52, 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

C52 is the ICD-10-CM diagnosis code for malignant neoplasm of vagina. Cancer that starts in the vagina, the muscular tube connecting the uterus to the external genitalia. C52 sits in the ICD-10-CM chapter for neoplasms (c00-d49), within the section covering malignant neoplasms of female genital organs (c51-c58).

Under the CMS-HCC V28 risk adjustment model, C52 maps to Bladder, Colorectal, and Other Cancers (HCC 22) with a source-labeled community, non-dual, aged reference coefficient of 0.363. 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.

Squamous cell carcinoma is the most common histological type; document this when present. For C52, 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 C52 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • •Squamous cell carcinoma is the most common histological type; document this when present
  • •Distinguish vaginal cancer from cervical cancer, as treatment and prognosis differ significantly

Clinical Significance

Primary vaginal cancer is rare, accounting for only 1-2% of gynecological malignancies. Most malignancies found in the vagina are metastatic from other sites (cervix, endometrium, vulva). Squamous cell carcinoma is the most common histological type, and there is a strong association with Human Papillomavirus infection and prior cervical cancer.

Documentation Requirements

  • ✓Confirmation of primary vaginal malignancy (not metastatic from another site)
  • ✓Histological type (squamous cell carcinoma, adenocarcinoma, melanoma, sarcoma)
  • ✓Tumor location within the vagina (upper, middle, lower third) for staging
  • ✓FIGO staging
  • ✓Depth of invasion
  • ✓Extension to adjacent structures (cervix, vulva, bladder, rectum)
  • ✓Human Papillomavirus status if documented
  • ✓Prior history of cervical cancer or hysterectomy

Excludes 1, Do NOT code together

  • carcinoma in situ of vagina (D07.2)

Commonly Confused Codes

  • •C53.9: Malignant neoplasm of cervix uteri; cervical cancer extending into the vagina should be coded as cervical primary, not vaginal primary
  • •C51.9: Malignant neoplasm of vulva; lower vaginal tumors may extend to the vulva: determine primary site
  • •C79.82: Secondary malignant neoplasm of genital organs; use when vaginal involvement is metastatic from another primary
  • •D07.2: Carcinoma in situ of vagina; preinvasive disease, not invasive malignancy

Code Hierarchy

└C52Malignant neoplasm of vagina
└C52Malignant neoplasm of vagina

For C52, 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.

C52 maps to CMS-HCC V28 category 22, Bladder, Colorectal, and Other Cancers. See the ICD-10 to HCC mapping hub for how the V28 crosswalk works. The mapping identifies a payment HCC category for C52. Review its source-labeled HCC coefficient above, check the RAF Calculator with complete member context for CMS-HCC V28 PY2026, and confirm the documentation the chart needs before the code is submitted. HCC Buddy shows no RAF score unless every required source and calculation check passes.

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