C78 ICD-10-CM Code: Secondary malignant neoplasm of respiratory and digestive organs
HCC Buddy Code Card
Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.
FY 2026 Apr update / Neoplasms (C00-D49) / Malignant neoplasms of ill-defined, other secondary and unspecified sites (C76-C80)
C78
Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidanceSecondary malignant neoplasm of respiratory and digestive organs
Secondary malignant neoplasm of respiratory and digestive organs
CMS-HCC V28
00
RAF 0
CMS-HCC V24
00
RAF 0
ACA/HHS
00
RAF 0
ESRD/PACE
00
RAF 0
RXHCC
00
RAF 0
Code Trumping
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Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for C78 in this effective period.
Excludes 2
Official- lymph node metastases (C77.0)
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for C78 in this effective period.
Excludes 1
Official- secondary carcinoid tumors of liver (C7B.02)
- secondary carcinoid tumors of peritoneum (C7B.04)
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for C78 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for C78 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for C78 in this effective period.
Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.
What This Code Means
C78 is the ICD-10-CM diagnosis code for secondary malignant neoplasm of respiratory and digestive organs. C78 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).
Header codes like C78 cannot be reported on claims directly, they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at C78's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for C78 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Excludes 1, Do NOT code together
- secondary carcinoid tumors of liver (C7B.02)
- secondary carcinoid tumors of peritoneum (C7B.04)
Excludes 2, Not included here, may code separately
- lymph node metastases (C77.0)