C62.01
BillableMalignant neoplasm of undescended right testis
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is C62.01 an HCC code?
Yes. C62.01 maps to Prostate, Breast, and Other Cancers and Tumors under the CMS-HCC V28 risk adjustment model (and Breast, Prostate, and Other Cancers and Tumors 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 C62.01
For C62.01to 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 C62.01 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
C62.01 is the ICD-10-CM diagnosis code for malignant neoplasm of undescended right testis. Cancer that develops in the right testis that has not descended into the scrotum. This is a malignant tumor of an undescended right testis. C62.01 sits in the ICD-10-CM chapter for neoplasms (c00-d49), within the section covering malignant neoplasms of male genital organs (c60-c63).
Under the CMS-HCC V28 risk adjustment model, C62.01 maps to Prostate, Breast, and Other Cancers and Tumors (HCC 23) with a community, non-dual, aged base RAF weight of 0.186. Under the older CMS-HCC V24 model, C62.01 maps to Breast, Prostate, and Other Cancers and Tumors (HCC 12) with a community, non-dual, aged base RAF weight of 0.150. 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.
Ensure documentation clearly specifies both the undescended status and right-sided location. Because C62.01 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 C62.01 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Ensure documentation clearly specifies both the undescended status and right-sided location
- •This code requires confirmation of laterality; do not use if side is unspecified
Clinical Significance
Cancer of the right undescended testis specifies both laterality and the critical clinical detail that the testis was cryptorchid, a known risk factor that increases testicular cancer risk 4-8 fold. This level of specificity supports surgical planning, risk stratification, and surveillance of the contralateral testis.
Documentation Requirements
- ✓Documentation of right-sided undescended testis with confirmed malignancy
- ✓Histologic type and grade
- ✓Serum tumor markers (AFP, beta-hCG, LDH)
- ✓TNM staging
- ✓Location of the undescended right testis prior to surgery
- ✓Contralateral testis status