C71.4 maps to CMS-HCC V28 20. A source-labeled RAF reference is available. Confirm the documented diagnosis and applicable coding requirements. MEAT criteria · RAF Calculator · free HCC coding tools

ICD-10-CM Code View

HCC Buddy Code Card

Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.

Code lookupC71.4

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)

C71.4

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

Malignant neoplasm of occipital lobe

Cancer that develops in the occipital lobe of the brain, which controls vision. This is a malignant brain tumor in the back part of the cerebrum.

Buddy Insight

Overview Risk Models Code Book Documentation Audit Notes Edition comparison

CMS-HCC V28

Mapped

HCC 20

Lung and Other Severe Cancers

Coefficient HCC 20: 1.136 (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 009

HHS-HCC 009 adult, RAF varies...

Code-level coefficient reference

ESRD/PACE

Mapped

HCC 10

Lymphoma and Other Cancers

Code-level coefficient reference

RXHCC

Mapped

HCC 22

Prostate, Breast, Bladder, an...

Code-level coefficient reference

Code Book Path

Official

C71Malignant neoplasm of brain C71.4Malignant neoplasm of occipital lobe

Inclusion Terms

Official

No inclusion terms are included in this display for C71.4. Check the code and parent instructions in the Code Book.

Excludes 2

Official

No Excludes 2 notes are included in this display for C71.4. Check the code and parent instructions in the Code Book.

Related Codes

Official

C71.0Malignant neoplasm of cerebrum, except lobes and ventricles C71.1Malignant neoplasm of frontal lobe C71.2Malignant neoplasm of temporal lobe C71.3Malignant neoplasm of parietal lobe C71.5Malignant neoplasm of cerebral ventricle

Includes

Official

No Includes notes are included in this display for C71.4. Check the code and parent instructions in the Code Book.

Excludes 1

Official

malignant neoplasm of cranial nerves (C72.2-C72.5)Inherited from C71
retrobulbar malignant neoplasm (C69.6-)Inherited from C71

Code First

Official

No Code First sequencing instructions are included in this display for C71.4. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for C71.4. Check the code and parent instructions in the Code Book.

Code Also

Official

No Code Also instructions are included in this display for C71.4. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance

Pathology confirming primary malignancy with histological type and grade

MRI brain documenting occipital lobe location

Visual field testing results documenting any visual field deficits

Laterality and relationship to the visual cortex

MEAT Support

HCC Buddy guidance

Pathology confirming primary malignancy with histological type and grade

MRI brain documenting occipital lobe location

Visual field testing results documenting any visual field deficits

Laterality and relationship to the visual cortex

Audit Caution

HCC Buddy guidance

Not specifying occipital lobe when imaging clearly identifies this location

Coding occipital metastases from systemic cancer as primary brain cancer

Using overlapping code for tumors confined to the occipital lobe

Failing to document associated visual field deficits that affect functional status

Common Mistakes

HCC Buddy guidance

C71.3 — Parietal lobe: parieto-occipital tumors may need careful localization or overlapping code

C71.0 — Cerebrum, unspecified: use C71.4 when occipital lobe is documented

C71.8 — Overlapping sites: use when tumor extends from occipital into adjacent lobes

C79.31 — Brain metastasis: metastatic lesions to the occipital lobe are common from lung and breast primaries

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 C71.4 an HCC code?

Yes. C71.4 (Malignant neoplasm of occipital lobe) maps to HCC 20, Lung and Other Severe Cancers under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 1.136. 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: C71.4 is billable and maps to V28 HCC 20, Lung and Other Severe Cancers. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code: C71.4
Description: Malignant neoplasm of occipital lobe
HCC (V28): HCC 20 — Lung and Other Severe Cancers
RAF reference coefficient: 1.136
Billable: Yes
Payment year: 2026

HCC Category Mapping

V28HCC 20, Lung and Other Severe Cancers

1.136

ESRDHCC 10, Lymphoma and Other Cancers

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 C71.4 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for C71.4

For C71.4, 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

C71.4 is the ICD-10-CM diagnosis code for malignant neoplasm of occipital lobe. Cancer that develops in the occipital lobe of the brain, which controls vision. This is a malignant brain tumor in the back part of the cerebrum. C71.4 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, C71.4 maps to Lung and Other Severe Cancers (HCC 20) with a source-labeled community, non-dual, aged reference coefficient of 1.136. 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 documentation specifies occipital lobe to differentiate from other brain locations. For C71.4, 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 C71.4 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Confirm documentation specifies occipital lobe to differentiate from other brain locations
•Document any visual disturbances reported by the patient, as these are typical with occipital lobe involvement

Clinical Significance

Occipital lobe malignancy affects the primary visual cortex, and tumors here characteristically cause contralateral visual field deficits (homonymous hemianopsia) that can significantly impair daily functioning. Despite being the smallest cerebral lobe, occipital tumors carry the same prognostic significance as other brain cancers and require aggressive multimodal treatment.

Documentation Requirements

✓Pathology confirming primary malignancy with histological type and grade
✓MRI brain documenting occipital lobe location
✓Visual field testing results documenting any visual field deficits
✓Laterality and relationship to the visual cortex
✓Treatment plan accounting for visual function preservation

Commonly Confused Codes

•C71.3: Parietal lobe: parieto-occipital tumors may need careful localization or overlapping code
•C71.0: Cerebrum, unspecified: use C71.4 when occipital lobe is documented
•C71.8: Overlapping sites: use when tumor extends from occipital into adjacent lobes
•C79.31: Brain metastasis: metastatic lesions to the occipital lobe are common from lung and breast primaries