C67.8
BillableMalignant neoplasm of overlapping sites of bladder
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is C67.8 an HCC code?
Yes. C67.8 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 C67.8
For C67.8to 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 C67.8 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
C67.8 is the ICD-10-CM diagnosis code for malignant neoplasm of overlapping sites of bladder. Cancer that involves multiple overlapping areas of the bladder, the organ that stores urine. C67.8 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, C67.8 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, C67.8 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.
Use this code when the tumor spans across two or more distinct sites within the bladder. Because C67.8 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 C67.8 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use this code when the tumor spans across two or more distinct sites within the bladder
- •Obtain pathology reports to confirm the extent of involvement across bladder regions
Clinical Significance
Overlapping sites of bladder cancer indicates a tumor that spans across two or more anatomical regions of the bladder, typically suggesting locally advanced disease. These tumors often carry a worse prognosis than site-confined tumors and frequently require more aggressive treatment approaches including radical cystectomy.
Documentation Requirements
- ✓Documentation explicitly stating the tumor involves multiple distinct bladder sites
- ✓Cystoscopy or surgical findings identifying the specific overlapping regions
- ✓Pathology confirming malignancy with histological type and grade
- ✓TNM staging reflecting the extent of involvement
- ✓Explanation of why a single site code cannot be assigned
Commonly Confused Codes
- •C67.4-C67.7 — Specific bladder wall codes: if the tumor can be localized to one primary site, use the specific code rather than overlapping
- •C67.9 — Bladder, unspecified: overlapping means multiple known sites; unspecified means the site is unknown — these are different clinical scenarios
- •C68.8 — Overlapping sites of urinary organs: use C67.8 when overlapping is within the bladder only; use C68.8 when spanning across different urinary organs