What is ICD-10 code C69.80?

C69.80 is the ICD-10-CM diagnosis code for Malignant neoplasm of overlapping sites of unspecified eye and adnexa. Cancer involving multiple overlapping structures of the eye and surrounding tissues when the specific eye is not identified. It belongs to the ICD-10-CM chapter for neoplasms (c00-d49). C69.80 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. C69.80 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. C69.80 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. C69.80 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

Which HCC does C69.80 map to under V28?

C69.80 maps to CMS-HCC V28 HCC 23 (Prostate, Breast, and Other Cancers and Tumors). The category numbers, labels, and conditions come from the CMS-HCC V28 model file for payment year 2026.

2026 ICD-10-CM C69.80: Malignant neoplasm

C69.80 maps to CMS-HCC V28 23. A source-labeled RAF reference is available. Confirm the documented diagnosis and applicable coding requirements. MEAT criteria · RAF Calculator · HCC coding software

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Code lookupC69.80

Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Neoplasms (C00-D49) / Malignant neoplasms of eye, brain and other parts of central nervous system (C69-C72)

C69.80

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

Malignant neoplasm of overlapping sites of unspecified eye and adnexa

Cancer involving multiple overlapping structures of the eye and surrounding tissues when the specific eye is not identified.

Buddy Insight

Overlapping sites of eye and adnexa malignancy indicates a tumor that spans multiple anatomical structures of the eye and its surrounding tissues, typically reflecting locally advanced disease.

Overview Risk Models Code Book Documentation Audit Notes Edition comparison

CMS-HCC V28

Mapped

HCC 23

Prostate, Breast, and Other C...

Code-level coefficient reference

CMS-HCC V24

Historical

Not used for standard CY2026 Medicare Advantage payment. Select a historical period to review V24.

Not used for CY2026 payment

ACA/HHS

Mapped

HCC 012

HHS-HCC 012 adult, RAF varies...

Code-level coefficient reference

ESRD/PACE

Mapped

HCC 12

Breast/Prostate/and Other Can...

Code-level coefficient reference

RXHCC

Mapped

HCC 22

Prostate, Breast, Bladder, an...

Code-level coefficient reference

Code Book Path

Official

C69Malignant neoplasm of eye and adnexa C69.8Malignant neoplasm of overlapping sites of eye and adnexa C69.80Malignant neoplasm of overlapping sites of unspecified eye and adnexa

Inclusion Terms

Official

No inclusion terms are included in this display for C69.80. Check the code and parent instructions in the Code Book.

Excludes 2

Official

No Excludes 2 notes are included in this display for C69.80. Check the code and parent instructions in the Code Book.

Related Codes

Official

C69.81Malignant neoplasm of overlapping sites of right eye and adnexa C69.82Malignant neoplasm of overlapping sites of left eye and adnexa

Includes

Official

No Includes notes are included in this display for C69.80. Check the code and parent instructions in the Code Book.

Excludes 1

Official

malignant neoplasm of connective tissue of eyelid (C49.0)Inherited from C69
malignant neoplasm of eyelid (skin) (C43.1-, C44.1-)Inherited from C69
malignant neoplasm of optic nerve (C72.3-)Inherited from C69

Code First

Official

No Code First sequencing instructions are included in this display for C69.80. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for C69.80. Check the code and parent instructions in the Code Book.

Code Also

Official

No Code Also instructions are included in this display for C69.80. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance

Pathology confirming malignancy with involvement of multiple eye/adnexal structures

Laterality — query required for this unspecified code

Imaging documenting the extent of involvement across multiple structures

Documentation of which specific structures are involved

MEAT Support

HCC Buddy guidance

Pathology confirming malignancy with involvement of multiple eye/adnexal structures

Laterality — query required for this unspecified code

Imaging documenting the extent of involvement across multiple structures

Documentation of which specific structures are involved

Audit Caution

HCC Buddy guidance

Using unspecified laterality when the affected side is documented

Confusing 'overlapping sites' with 'unspecified site' — overlapping means multiple known sites, unspecified means unknown

Coding each involved structure separately rather than using the overlapping sites code when the tumor spans boundaries

Common Mistakes

HCC Buddy guidance

C69.81/C69.82 — Right/left overlapping sites: use laterality-specific codes when the affected eye is known

C69.60-C69.62 — Orbital malignancy: if confined to the orbit without involving the eye proper, use orbital codes

C69.90-C69.92 — Unspecified eye: overlapping sites implies multiple known sites; unspecified means the site is unknown

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 C69.80 an HCC code?

Yes. C69.80 (Malignant neoplasm of overlapping sites of unspecified eye and adnexa) maps to HCC 23, Prostate, Breast, and Other Cancers and Tumors under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 0.186. 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: C69.80 is billable and maps to V28 HCC 23, Prostate, Breast, and Other Cancers and Tumors. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code: C69.80
Description: Malignant neoplasm of overlapping sites of unspecified eye and adnexa
HCC (V28): HCC 23 — Prostate, Breast, and Other Cancers and Tumors
RAF reference coefficient: 0.186
Billable: Yes
Payment year: 2026

HCC Category Mapping

V28HCC 23, Prostate, Breast, and Other Cancers and Tumors

0.186

ESRDHCC 12, Breast/Prostate/and Other Cancers and Tumors

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 C69.80 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for C69.80

For C69.80, 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

C69.80 is the ICD-10-CM diagnosis code for malignant neoplasm of overlapping sites of unspecified eye and adnexa. Cancer involving multiple overlapping structures of the eye and surrounding tissues when the specific eye is not identified. C69.80 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, C69.80 maps to Prostate, Breast, and Other Cancers and Tumors (HCC 23) with a source-labeled community, non-dual, aged reference coefficient of 0.186. No V24 mapping is shown for C69.80; 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.

Use when tumor involves more than one anatomical site of the eye/adnexa. For C69.80, 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 C69.80 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Use when tumor involves more than one anatomical site of the eye/adnexa
•Query provider for laterality if not clearly documented

Clinical Significance

Overlapping sites of eye and adnexa malignancy indicates a tumor that spans multiple anatomical structures of the eye and its surrounding tissues, typically reflecting locally advanced disease. These complex tumors require multidisciplinary surgical and oncologic management and may necessitate orbital exenteration for adequate treatment.

Documentation Requirements

✓Pathology confirming malignancy with involvement of multiple eye/adnexal structures
✓Laterality — query required for this unspecified code
✓Imaging documenting the extent of involvement across multiple structures
✓Documentation of which specific structures are involved
✓Staging reflecting the multi-site nature of the disease

Commonly Confused Codes

•C69.81/C69.82: Right/left overlapping sites: use laterality-specific codes when the affected eye is known
•C69.60-C69.62: Orbital malignancy: if confined to the orbit without involving the eye proper, use orbital codes
•C69.90-C69.92: Unspecified eye: overlapping sites implies multiple known sites; unspecified means the site is unknown