What is ICD-10 code C74.90?

C74.90 is the ICD-10-CM diagnosis code for Malignant neoplasm of unspecified part of unspecified adrenal gland. Cancer of an adrenal gland where both the specific part of the gland and which side (left or right) are not specified. It belongs to the ICD-10-CM chapter for neoplasms (c00-d49). C74.90 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. C74.90 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. C74.90 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. C74.90 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.

What is the V28 vs V24 difference for C74.90?

CMS phased in the V28 risk adjustment model over payment years 2024 (33%), 2025 (67%), and 2026 (100%), replacing V24. V28 consolidates HCC categories, removes some lower-acuity conditions, and recalibrates RAF weights across the entire model. For C74.90, V28 maps to Bladder, Colorectal, and Other Cancers at RAF 0.363 while V24 mapped to Lymphoma and Other Cancers at RAF 0.675. Both models can still appear in legacy data and in payer-specific lookback periods.

What should coders know when reporting C74.90?

This is the least specific adrenal cancer code; use only when documentation does not specify laterality or whether the tumor involves cortex or medulla Query provider for additional specificity regarding side (left/right) and anatomical region (cortex/medulla) to assign more precise codes Because C74.90 maps to a payment HCC, the documentation must also satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's risk adjustment score.

2026 ICD-10-CM C74.90: Malignant neoplasm

ICD-10-CM Code View

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Code lookupC74.90Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Neoplasms (C00-D49) / Malignant neoplasms of thyroid and other endocrine glands (C73-C75)

C74.90

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

Malignant neoplasm of unspecified part of unspecified adrenal gland

Cancer of an adrenal gland where both the specific part of the gland and which side (left or right) are not specified.

Buddy Insight

Malignant neoplasm of unspecified part of unspecified adrenal gland is the least specific adrenal cancer code, lacking both laterality and compartment (cortex vs.

CMS-HCC V28

Mapped

HCC 22

Bladder, Colorectal, and Othe...

RAF 0.363

CMS-HCC V24

Mapped

HCC 10

Lymphoma and Other Cancers

RAF 0.675

ACA/HHS

N/A

—

Not risk-adjusted for this model/period.

Not mapped

ESRD/PACE

Mapped

HCC 10

Lymphoma and Other Cancers

RAF 0.111

RXHCC

Mapped

HCC 22

Cancer, Other Specified Sites

RAF 0.124

Code Book Path

Official

C74Malignant neoplasm of adrenal gland

C74.9Malignant neoplasm of unspecified part of adrenal gland

C74.90Malignant neoplasm of unspecified part of unspecified adrenal gland

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for C74.90 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for C74.90 in this effective period.

Related Child Codes

Official

C74.91Malignant neoplasm of unspecified part of right adrenal gland

C74.92Malignant neoplasm of unspecified part of left adrenal gland

Includes

Official

ICD-10-CM does not list Includes notes for C74.90 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for C74.90 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for C74.90 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for C74.90 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for C74.90 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Documentation confirming adrenal malignancy

Provider query for laterality (right/left) to assign C74.91 or C74.92

Provider query for compartment (cortex/medulla) to assign C74.0x or C74.1x codes

Review imaging reports which typically specify side and compartment

MEAT Support

HCC Buddy guidance

Documentation confirming adrenal malignancy

Provider query for laterality (right/left) to assign C74.91 or C74.92

Provider query for compartment (cortex/medulla) to assign C74.0x or C74.1x codes

Review imaging reports which typically specify side and compartment

Audit Caution

HCC Buddy guidance

Using this maximally unspecified code when documentation supports a more specific code

Not reviewing imaging and surgical reports for laterality and compartment information

Coding metastatic disease to the adrenal glands as primary adrenal malignancy

Failing to query the provider for specificity — this code attracts audit attention

Common Mistakes

HCC Buddy guidance

C74.00-C74.02 — Adrenal cortex codes: Use when cortex origin is documented

C74.10-C74.12 — Adrenal medulla codes: Use when medulla origin is documented

C74.91/C74.92 — Right/left adrenal unspecified part: Use when laterality is known but compartment is not

C79.70 — Secondary malignant neoplasm of adrenal gland: Metastatic disease, not primary malignancy

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 C74.90 an HCC code?

Yes. C74.90 (Malignant neoplasm of unspecified part of unspecified adrenal gland) maps to Bladder, Colorectal, and Other Cancers under the CMS-HCC V28 risk adjustment model (and Lymphoma and Other Cancers under V24), with a community non-dual aged RAF of 0.363. It is billable for payment year 2026.

Coder answer: C74.90 is billable and maps to V28 HCC 22, Bladder, Colorectal, and Other Cancers. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code: C74.90
Description: Malignant neoplasm of unspecified part of unspecified adrenal gland
HCC (V28): HCC 22 — Bladder, Colorectal, and Other Cancers
RAF: 0.363
Billable: Yes
Payment year: 2026

HCC Category Mapping

V28HCC 22, Bladder, Colorectal, and Other Cancers

0.363

V24HCC 10, Lymphoma and Other Cancers

0.675

ESRDHCC 10, Lymphoma and Other Cancers

0.111

RxHCCHCC 22, Cancer, Other Specified Sites

0.124

Each model's RAF is its CMS base weight for that model's standard population, so 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 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.

Work C74.90 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for C74.90

For C74.90 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 C74.90 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

C74.90 is the ICD-10-CM diagnosis code for malignant neoplasm of unspecified part of unspecified adrenal gland. Cancer of an adrenal gland where both the specific part of the gland and which side (left or right) are not specified. C74.90 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, C74.90 maps to Bladder, Colorectal, and Other Cancers (HCC 22) with a community, non-dual, aged base RAF weight of 0.363. Under the older CMS-HCC V24 model, C74.90 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 is the least specific adrenal cancer code; use only when documentation does not specify laterality or whether the tumor involves cortex or medulla. Because C74.90 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 C74.90 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•This is the least specific adrenal cancer code; use only when documentation does not specify laterality or whether the tumor involves cortex or medulla
•Query provider for additional specificity regarding side (left/right) and anatomical region (cortex/medulla) to assign more precise codes

Clinical Significance

Malignant neoplasm of unspecified part of unspecified adrenal gland is the least specific adrenal cancer code, lacking both laterality and compartment (cortex vs. medulla) detail. This code should rarely be used as imaging and pathology almost always identify the affected side and compartment. It represents a documentation gap that should be addressed through provider query.

Documentation Requirements

✓Documentation confirming adrenal malignancy
✓Provider query for laterality (right/left) to assign C74.91 or C74.92
✓Provider query for compartment (cortex/medulla) to assign C74.0x or C74.1x codes
✓Review imaging reports which typically specify side and compartment
✓Treatment status and management plan

Commonly Confused Codes

•C74.00-C74.02: Adrenal cortex codes: Use when cortex origin is documented
•C74.10-C74.12: Adrenal medulla codes: Use when medulla origin is documented
•C74.91/C74.92: Right/left adrenal unspecified part: Use when laterality is known but compartment is not
•C79.70: Secondary malignant neoplasm of adrenal gland: Metastatic disease, not primary malignancy
•D35.00: Benign neoplasm of adrenal gland: Confirm malignancy