C74.01
BillableMalignant neoplasm of cortex of right adrenal gland
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is C74.01 an HCC code?
Yes. C74.01 maps to Colorectal, Bladder, and Other 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 C74.01
For C74.01 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 C74.01 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
C74.01 is the ICD-10-CM diagnosis code for malignant neoplasm of cortex of right adrenal gland. This code describes cancer that has started in the outer layer (cortex) of the right adrenal gland, which is a small hormone-producing gland located above the right kidney. This is a malignant tumor that requires treatment and monitoring. C74.01 sits in the ICD-10-CM chapter for neoplasms (c00-d49), within the section covering malignant neoplasms of thyroid and other endocrine glands (c73-c75).
Under the CMS-HCC V28 risk adjustment model, C74.01 maps to Colorectal, Bladder, and Other Cancers (HCC 22) with a community, non-dual, aged base RAF weight of 0.000. Under the older CMS-HCC V24 model, C74.01 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.
Ensure documentation specifies the right adrenal gland (not left or bilateral) and confirms the tumor originates in the cortex rather than the medulla, as these distinctions affect code selection. Because C74.01 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 C74.01 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Ensure documentation specifies the right adrenal gland (not left or bilateral) and confirms the tumor originates in the cortex rather than the medulla, as these distinctions affect code selection
- •This code is used for primary malignant neoplasms only; if the cancer has metastasized from another site, use a secondary neoplasm code instead
Clinical Significance
Malignant neoplasm of the cortex of the right adrenal gland specifies adrenocortical carcinoma on the right side. Right-sided adrenal tumors may present unique surgical challenges due to proximity to the inferior vena cava. This lateralized code provides maximum specificity and is preferred over the unspecified version.
Documentation Requirements
- ✓Pathology confirming adrenocortical carcinoma of the right adrenal gland
- ✓Documentation confirming right-sided involvement
- ✓Hormonal evaluation and functional status of the tumor
- ✓Staging information and extent of disease
- ✓Documentation confirming cortex as tissue of origin, not medulla