What is ICD-10 code C76.0?

C76.0 is the ICD-10-CM diagnosis code for Malignant neoplasm of head, face and neck. A malignant (cancerous) tumor located in the head, face, or neck region, but the specific tissue or organ of origin is not further specified. It belongs to the ICD-10-CM chapter for neoplasms (c00-d49). C76.0 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. C76.0 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. C76.0 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. C76.0 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.

Which HCC does C76.0 map to under V28?

C76.0 maps to CMS-HCC V28 HCC 23 (Prostate, Breast, and Other Cancers and Tumors). The category numbers, labels, and conditions come from the CMS-HCC V28 model file for payment year 2026.

2026 ICD-10-CM C76.0: Malignant neoplasm of head

C76.0 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 lookupC76.0

Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Neoplasms (C00-D49) / Malignant neoplasms of ill-defined, other secondary and unspecified sites (C76-C80)

C76.0

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

Malignant neoplasm of head, face and neck

A malignant (cancerous) tumor located in the head, face, or neck region, but the specific tissue or organ of origin is not further specified.

Buddy Insight

Overview Risk Models Code Book Documentation Audit Notes Edition comparison

CMS-HCC V28

Mapped

HCC 23

Prostate, Breast, and Other C...

Code-level coefficient reference

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

C76Malignant neoplasm of other and ill-defined sites C76.0Malignant neoplasm of head, face and neck

Inclusion Terms

Official

Malignant neoplasm of cheek NOS
Malignant neoplasm of nose NOS

Excludes 2

Official

No Excludes 2 notes are included in this display for C76.0. Check the code and parent instructions in the Code Book.

Related Codes

Official

C76.1Malignant neoplasm of thorax C76.2Malignant neoplasm of abdomen C76.3Malignant neoplasm of pelvis C76.4Malignant neoplasm of upper limb C76.5Malignant neoplasm of lower limb

Includes

Official

No Includes notes are included in this display for C76.0. Check the code and parent instructions in the Code Book.

Excludes 1

Official

malignant neoplasm of female genitourinary tract NOS (C57.9)Inherited from C76
malignant neoplasm of male genitourinary tract NOS (C63.9)Inherited from C76
malignant neoplasm of lymphoid, hematopoietic and related tissue (C81-C96)Inherited from C76
malignant neoplasm of skin (C44.-)Inherited from C76
malignant neoplasm of unspecified site NOS (C80.1)Inherited from C76

Code First

Official

No Code First sequencing instructions are included in this display for C76.0. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for C76.0. Check the code and parent instructions in the Code Book.

Code Also

Official

No Code Also instructions are included in this display for C76.0. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance

Documentation confirming malignancy in the head, face, or neck region

Evidence that the site of origin cannot be determined despite workup

Pathology report with histological type

Imaging documenting the extent and location of the tumor

MEAT Support

HCC Buddy guidance

Documentation confirming malignancy in the head, face, or neck region

Evidence that the site of origin cannot be determined despite workup

Pathology report with histological type

Imaging documenting the extent and location of the tumor

Audit Caution

HCC Buddy guidance

Using this code when a more specific site code exists — always attempt to identify the organ of origin

Coding cancers of unknown primary presenting in cervical lymph nodes as C76.0 instead of C80.0 or C77.0

Not reviewing pathology that may identify tissue type and suggest organ of origin

Confusing this ill-defined site code with codes for specific head/neck structures (larynx, pharynx, oral cavity)

Common Mistakes

HCC Buddy guidance

C10-C14 — Malignant neoplasms of lip, oral cavity, pharynx: Use when mucosal origin is identified

C43.30-C43.39 — Melanoma of face: Use when skin melanoma of specific facial site is documented

C76.8 — Other specified ill-defined sites: Use for ill-defined sites other than head/neck

C80.0 — Disseminated malignant neoplasm, unspecified: Use when cancer is widespread without identifiable primary

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 C76.0 an HCC code?

Yes. C76.0 (Malignant neoplasm of head, face and neck) 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: C76.0 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: C76.0
Description: Malignant neoplasm of head, face and neck
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 C76.0 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for C76.0

For C76.0, 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

C76.0 is the ICD-10-CM diagnosis code for malignant neoplasm of head, face and neck. A malignant (cancerous) tumor located in the head, face, or neck region, but the specific tissue or organ of origin is not further specified. C76.0 sits in the ICD-10-CM chapter for neoplasms (c00-d49), within the section covering malignant neoplasms of ill-defined, other secondary and unspecified sites (c76-c80).

Under the CMS-HCC V28 risk adjustment model, C76.0 maps to Prostate, Breast, and Other Cancers and Tumors (HCC 23) with a source-labeled community, non-dual, aged reference coefficient of 0.186. No V24 mapping is shown for C76.0; use the applicable model and payment year when reviewing the V28 mapping. 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.

This code is used when the primary site is head/face/neck but histology or specific organ is unknown. For C76.0, 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 C76.0 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•This code is used when the primary site is head/face/neck but histology or specific organ is unknown
•If a specific organ (thyroid, larynx, etc.) is identified, use the more specific C-code for that organ

Clinical Significance

Malignant neoplasm of head, face, and neck (ill-defined site) is used when a malignancy is documented in the head, face, or neck region but the specific tissue or organ of origin cannot be determined. This code applies to overlapping or contiguous sites where the point of origin is unclear. It should not be used when a more specific anatomical site code is available.

Documentation Requirements

✓Documentation confirming malignancy in the head, face, or neck region
✓Evidence that the site of origin cannot be determined despite workup
✓Pathology report with histological type
✓Imaging documenting the extent and location of the tumor
✓Provider attestation that the specific organ of origin is unknown

Commonly Confused Codes

•C10-C14: Malignant neoplasms of lip, oral cavity, pharynx: Use when mucosal origin is identified
•C43.30-C43.39: Melanoma of face: Use when skin melanoma of specific facial site is documented
•C76.8: Other specified ill-defined sites: Use for ill-defined sites other than head/neck
•C80.0: Disseminated malignant neoplasm, unspecified: Use when cancer is widespread without identifiable primary
•C77.0: Secondary neoplasm of lymph nodes of head/neck: Lymph node metastasis, not primary tumor