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C67.0 ICD-10-CM Code: Malignant neoplasm of trigone of bladder

C67.0 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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Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.

Code lookupC67.0

FY 2026 Apr update / Neoplasms (C00-D49) / Malignant neoplasms of urinary tract (C64-C68)

C67.0

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

Malignant neoplasm of trigone of bladder

Cancer that develops in the trigone, which is the triangular area at the base of the bladder where the ureters enter.

Buddy the Bee presenting code insight

Buddy Insight

Trigone of the bladder is the triangular region at the base formed by the two ureteral orifices and the internal urethral orifice.

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

HCC 22

Code-level coefficient reference

Code Book Path

Official
C67Malignant neoplasm of bladderC67.0Malignant neoplasm of trigone of bladder

Inclusion Terms

Official

No inclusion terms are included in this display for C67.0. Check the code and parent instructions in the Code Book.

Excludes 2

Official

No Excludes 2 notes are included in this display for C67.0. Check the code and parent instructions in the Code Book.

Related Codes

Official
C67.1Malignant neoplasm of dome of bladderC67.2Malignant neoplasm of lateral wall of bladderC67.3Malignant neoplasm of anterior wall of bladderC67.4Malignant neoplasm of posterior wall of bladderC67.5Malignant neoplasm of bladder neck

Includes

Official

No Includes notes are included in this display for C67.0. Check the code and parent instructions in the Code Book.

Excludes 1

Official

No Excludes 1 notes are included in this display for C67.0. Check the code and parent instructions in the Code Book.

Code First

Official

No Code First sequencing instructions are included in this display for C67.0. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for C67.0. Check the code and parent instructions in the Code Book.

Code Also

Official

No Code Also instructions are included in this display for C67.0. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance
Cystoscopy or pathology report confirming malignancy at the trigone
Histologic type (urothelial carcinoma in >90% of cases)
Grade and stage (Ta, T1, T2, etc.)
Whether muscle-invasive or non-muscle-invasive

MEAT Support

HCC Buddy guidance
Cystoscopy or pathology report confirming malignancy at the trigone
Histologic type (urothelial carcinoma in >90% of cases)
Grade and stage (Ta, T1, T2, etc.)
Whether muscle-invasive or non-muscle-invasive

Audit Caution

HCC Buddy guidance
Using unspecified bladder cancer when the cystoscopy report identifies the trigone as the tumor site
Confusing trigone with bladder neck — the trigone is a triangular area, the bladder neck is the outlet
Not recognizing that trigonal tumors frequently cause ureteral obstruction requiring additional documentation
Coding bladder cancer in situ at the trigone as invasive cancer — use D09.0 for in situ

Common Mistakes

HCC Buddy guidance
C67.5 — Bladder neck cancer; the trigone and bladder neck are adjacent but distinct regions
C67.6 — Ureteric orifice cancer; the ureteral openings are within the trigone but have their own code
C67.9 — Unspecified bladder; use C67.0 when trigone is specifically documented
C67.1-C67.4 — Other bladder wall sites; each has specific anatomical boundaries

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 C67.0 an HCC code?

Yes. C67.0 (Malignant neoplasm of trigone of bladder) 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: C67.0 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
C67.0
Description
Malignant neoplasm of trigone of bladder
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
RxHCCHCC 22, Prostate, Breast, Bladder, and Other Cancers and Tumors
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 C67.0 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for C67.0

For C67.0, 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

C67.0 is the ICD-10-CM diagnosis code for malignant neoplasm of trigone of bladder. Cancer that develops in the trigone, which is the triangular area at the base of the bladder where the ureters enter. C67.0 sits in the ICD-10-CM chapter for neoplasms (c00-d49), within the section covering malignant neoplasms of urinary tract (c64-c68).

Under the CMS-HCC V28 risk adjustment model, C67.0 maps to Bladder, Colorectal, and Other Cancers (HCC 22) with a source-labeled community, non-dual, aged reference coefficient of 0.363. No V24 mapping is shown for C67.0; 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.

The trigone is a specific anatomical location; ensure documentation specifies this site. For C67.0, 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 C67.0 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • •The trigone is a specific anatomical location; ensure documentation specifies this site
  • •This location is clinically significant as it affects urine flow from both kidneys

Clinical Significance

Trigone of the bladder is the triangular region at the base formed by the two ureteral orifices and the internal urethral orifice. Trigonal tumors are clinically significant because of their proximity to both ureteral orifices (risk of obstruction and hydronephrosis) and the bladder neck (risk of urethral involvement). Accurate subsite coding supports treatment planning and surgical approach determination.

Documentation Requirements

  • ✓Cystoscopy or pathology report confirming malignancy at the trigone
  • ✓Histologic type (urothelial carcinoma in >90% of cases)
  • ✓Grade and stage (Ta, T1, T2, etc.)
  • ✓Whether muscle-invasive or non-muscle-invasive
  • ✓Ureteral orifice involvement or hydronephrosis status
  • ✓Treatment plan (transurethral resection, intravesical therapy, cystectomy)

Commonly Confused Codes

  • •C67.5: Bladder neck cancer; the trigone and bladder neck are adjacent but distinct regions
  • •C67.6: Ureteric orifice cancer; the ureteral openings are within the trigone but have their own code
  • •C67.9: Unspecified bladder; use C67.0 when trigone is specifically documented
  • •C67.1-C67.4: Other bladder wall sites; each has specific anatomical boundaries

Child Codes

C67.0Malignant neoplasm of trigone of bladder
HCC 22
C67.1Malignant neoplasm of dome of bladder
HCC 22
C67.2Malignant neoplasm of lateral wall of bladder
HCC 22
C67.3Malignant neoplasm of anterior wall of bladder
HCC 22
C67.4Malignant neoplasm of posterior wall of bladder
HCC 22
C67.5Malignant neoplasm of bladder neck
HCC 22
C67.6Malignant neoplasm of ureteric orifice
HCC 22
C67.7Malignant neoplasm of urachus
HCC 22
C67.8Malignant neoplasm of overlapping sites of bladder
HCC 22
C67.9Malignant neoplasm of bladder, unspecified
HCC 22

Code Hierarchy

└C67Malignant neoplasm of bladder└C67.0Malignant neoplasm of trigone of bladder
└C67.0Malignant neoplasm of trigone of bladder

Also searched as

  • C67 0
  • C670

For C67.0, 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.

C67.0 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 C67.0. 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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