C69.32
BillableMalignant neoplasm of left choroid
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is C69.32 an HCC code?
Yes. C69.32 maps to Melanoma and Other Skin Cancers 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 C69.32
For C69.32 to 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 C69.32 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
C69.32 is the ICD-10-CM diagnosis code for malignant neoplasm of left choroid. A cancerous tumor that develops in the left choroid, the blood vessel layer located between the retina and the outer eye wall. C69.32 sits in the ICD-10-CM chapter for neoplasms (c00-d49), within the section covering malignant neoplasms of eye, brain and other parts of central nervous system (c69-c72).
Under the CMS-HCC V28 risk adjustment model, C69.32 maps to Melanoma and Other Skin Cancers (HCC 23) with a community, non-dual, aged base RAF weight of 0.251. Under the older CMS-HCC V24 model, C69.32 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.
Verify left eye is clearly documented to prevent laterality errors. Because C69.32 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 C69.32 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify left eye is clearly documented to prevent laterality errors
- •Document any associated vision loss or eye symptoms for complete clinical picture
Clinical Significance
Left choroidal malignancy carries identical prognostic significance and treatment requirements as right-sided disease. Accurate laterality documentation is a patient safety requirement for surgical procedures including brachytherapy plaque placement, where wrong-side surgery prevention protocols mandate clear laterality identification in all documentation.
Documentation Requirements
- ✓Clinical diagnosis or pathology confirming choroidal malignancy
- ✓Explicit documentation of left eye involvement
- ✓Tumor measurements by ultrasonography
- ✓Staging and treatment plan
- ✓Systemic metastatic workup documentation
Commonly Confused Codes
- •C69.31 — Right choroid: laterality must be verified from clinical notes
- •C69.42 — Left ciliary body: choroid and ciliary body are adjacent but distinct uveal structures
- •C69.22 — Left retina: confirm primary site is choroid, not retina
- •C69.30 — Unspecified choroid: use C69.32 when left eye is documented