C72.41
BillableMalignant neoplasm of right acoustic nerve
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is C72.41 an HCC code?
Yes. C72.41 maps to Lung and Other Severe Cancers under the CMS-HCC V28 risk adjustment model (and Lymphoma 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 C72.41
For C72.41 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 C72.41 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
C72.41 is the ICD-10-CM diagnosis code for malignant neoplasm of right acoustic nerve. A malignant (cancerous) tumor of the right acoustic nerve, which is involved in hearing and balance on the right side. C72.41 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, C72.41 maps to Lung and Other Severe Cancers (HCC 20) with a community, non-dual, aged base RAF weight of 0.000. Under the older CMS-HCC V24 model, C72.41 maps to Lymphoma and Other Cancers (HCC 10) with a community, non-dual, aged base RAF weight of 0.675. 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.
This code specifies the right side; use C72.42 for left side and verify laterality in documentation. Because C72.41 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 C72.41 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This code specifies the right side; use C72.42 for left side and verify laterality in documentation
- •Acoustic nerve tumors may present with hearing loss or balance problems; document affected side clearly
Clinical Significance
Malignant neoplasm of the right acoustic nerve is a rare malignancy of cranial nerve VIII on the right side. Unlike the far more common benign vestibular schwannoma, a malignant acoustic nerve tumor carries a worse prognosis and typically requires aggressive multimodal treatment. Accurate distinction between benign and malignant is essential for appropriate risk adjustment.
Documentation Requirements
- ✓Pathology report explicitly confirming malignancy of the right acoustic nerve
- ✓Documentation of right-sided involvement on imaging
- ✓Audiometric and vestibular function testing results for the right ear
- ✓Tumor size, extent, and relationship to adjacent structures (facial nerve, brainstem)
- ✓Treatment plan and current management status
Commonly Confused Codes
- •C72.42 — Malignant neoplasm of left acoustic nerve: Laterality error; verify right side
- •D33.3 — Benign neoplasm of cranial nerves: Benign vestibular schwannoma is far more common; verify malignancy
- •C72.40 — Unspecified acoustic nerve: Use C72.41 when right side is documented
- •C71.6 — Malignant neoplasm of cerebellum: Cerebellopontine angle tumors may involve but do not originate from the acoustic nerve