C67.7
BillableMalignant neoplasm of urachus
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is C67.7 an HCC code?
Yes. C67.7 maps to Bladder, Colorectal, and Other Cancers under the CMS-HCC V28 risk adjustment model (and Colorectal, Bladder, 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 C67.7
For C67.7to 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 C67.7 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
C67.7 is the ICD-10-CM diagnosis code for malignant neoplasm of urachus. Cancer that develops from the urachus, a remnant embryological structure in the bladder dome that normally disappears before birth. C67.7 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, C67.7 maps to Bladder, Colorectal, and Other Cancers (HCC 22) with a community, non-dual, aged base RAF weight of 0.363. Under the older CMS-HCC V24 model, C67.7 maps to Colorectal, Bladder, and Other Cancers (HCC 11) with a community, non-dual, aged base RAF weight of 0.307. 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.
Urachal cancer is rare; ensure documentation specifically mentions urachus involvement. Because C67.7 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 C67.7 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Urachal cancer is rare; ensure documentation specifically mentions urachus involvement
- •Distinguish from dome of bladder cancer (C67.1) which is a different entity
Clinical Significance
Urachal carcinoma is a rare and aggressive form of bladder cancer arising from a vestigial embryological structure connecting the bladder to the umbilicus. It accounts for less than 1% of all bladder cancers and typically presents as adenocarcinoma (unlike the transitional cell carcinoma predominant in other bladder sites), often diagnosed at advanced stages due to its location in the bladder dome.
Documentation Requirements
- ✓Pathology confirming urachal origin with histological type (usually adenocarcinoma, mucinous, or signet ring)
- ✓Documentation explicitly stating urachus involvement, not simply 'dome of bladder'
- ✓Imaging showing midline anterior mass at the bladder dome extending toward the umbilicus
- ✓Staging per Sheldon classification or TNM system
- ✓Distinction from primary bladder dome cancer versus true urachal remnant origin
Commonly Confused Codes
- •C67.1 — Dome of bladder: urachal cancer arises from the urachus at the dome but is a distinct entity; dome cancers are typically transitional cell while urachal cancers are adenocarcinoma
- •C67.8 — Overlapping sites: use when urachal tumor extends beyond the dome into other bladder regions
- •C76.3 — Malignant neoplasm of pelvis: advanced urachal cancer may extend beyond the bladder into the pelvis