C69.82 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 Buddy coding tools

ICD-10-CM Code View

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Code lookupC69.82

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)

C69.82

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

Malignant neoplasm of overlapping sites of left eye and adnexa

Cancer involving multiple overlapping structures of the left eye and surrounding tissues.

Buddy Insight

Left eye and adnexa overlapping malignancy represents advanced multi-structure ocular cancer requiring aggressive treatment.

Overview Risk Models Code Book Documentation Audit Notes Edition comparison

CMS-HCC V28

Mapped

HCC 23

Prostate, Breast, and Other C...

Coefficient HCC 23: 0.186 (Community Non-Dual Aged (CNA))

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

Inclusion Terms

Official

No inclusion terms are included in this display for C69.82. Check the code and parent instructions in the Code Book.

Excludes 2

Official

No Excludes 2 notes are included in this display for C69.82. Check the code and parent instructions in the Code Book.

Related Codes

Official

C69.80Malignant neoplasm of overlapping sites of unspecified eye and adnexa C69.81Malignant neoplasm of overlapping sites of right eye and adnexa

Includes

Official

No Includes notes are included in this display for C69.82. 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 C69.82. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for C69.82. Check the code and parent instructions in the Code Book.

Code Also

Official

No Code Also instructions are included in this display for C69.82. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance

Pathology confirming malignancy involving multiple left eye/adnexal structures

Explicit documentation of left side involvement

Detailed imaging of all involved structures

Assessment of the extent of disease for treatment planning

MEAT Support

HCC Buddy guidance

Pathology confirming malignancy involving multiple left eye/adnexal structures

Explicit documentation of left side involvement

Detailed imaging of all involved structures

Assessment of the extent of disease for treatment planning

Audit Caution

HCC Buddy guidance

Laterality reversal errors affecting surgical planning

Using a single-structure code instead of the overlapping sites code

Coding unspecified laterality when left side is documented

Common Mistakes

HCC Buddy guidance

C69.81 — Right eye overlapping sites: verify laterality carefully

C69.62 — Left orbit only: use overlapping code when eye structures beyond the orbit are involved

C69.80 — Unspecified eye overlapping sites: use C69.82 when left side is documented

C69.92 — Unspecified site of left eye: use overlapping code when multiple specific sites are involved

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 C69.82 an HCC code?

Yes. C69.82 (Malignant neoplasm of overlapping sites of left 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: C69.82 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: C69.82
Description: Malignant neoplasm of overlapping sites of left 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 C69.82 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for C69.82

For C69.82, 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

C69.82 is the ICD-10-CM diagnosis code for malignant neoplasm of overlapping sites of left eye and adnexa. Cancer involving multiple overlapping structures of the left eye and surrounding tissues. C69.82 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, C69.82 maps to Prostate, Breast, and Other Cancers and Tumors (HCC 23) with a source-labeled community, non-dual, aged reference coefficient of 0.186. 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.

Confirm left side and overlapping sites are documented. For C69.82, 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 C69.82 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Confirm left side and overlapping sites are documented
•Review pathology to identify all involved anatomical structures

Clinical Significance

Left eye and adnexa overlapping malignancy represents advanced multi-structure ocular cancer requiring aggressive treatment. Accurate laterality coding is a patient safety priority to prevent wrong-side surgical interventions, particularly when orbital exenteration is planned.

Documentation Requirements

✓Pathology confirming malignancy involving multiple left eye/adnexal structures
✓Explicit documentation of left side involvement
✓Detailed imaging of all involved structures
✓Assessment of the extent of disease for treatment planning
✓Documentation of visual function status

Commonly Confused Codes

•C69.81: Right eye overlapping sites: verify laterality carefully
•C69.62: Left orbit only: use overlapping code when eye structures beyond the orbit are involved
•C69.80: Unspecified eye overlapping sites: use C69.82 when left side is documented
•C69.92: Unspecified site of left eye: use overlapping code when multiple specific sites are involved