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C78 ICD-10-CM Code: Secondary malignant neoplasm of respiratory and digestive organs

C78 is not a CMS-HCC payment code. MEAT criteria · RAF calculator · free HCC coding tools

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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 guidance

Secondary malignant neoplasm of respiratory and digestive organs

Secondary malignant neoplasm of respiratory and digestive organs

CMS-HCC V28

N/A

Not mapped

CMS-HCC V24

N/A

Not mapped

ACA/HHS

N/A

Not mapped

ESRD/PACE

N/A

Not mapped

RXHCC

N/A

Not mapped

Code Book Path

Official
C7Malignant neoplasms of ill-defined, other secondary and unspecified sites (C76-C80)
C78Secondary malignant neoplasm of respiratory and digestive organs

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for C78 in this effective period.

Excludes 2

Official
  • lymph node metastases (C77.0)

Related Child Codes

Official
C78.0Secondary malignant neoplasm of lung
C78.1Secondary malignant neoplasm of mediastinum
C78.2Secondary malignant neoplasm of pleura
C78.3Secondary malignant neoplasm of other and unspecified respiratory organs
C78.4Secondary malignant neoplasm of small intestine

Includes

Official

ICD-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

Official

ICD-10-CM does not list Code First sequencing instructions for C78 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for C78 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for C78 in this effective period.

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 →

Code
C78
Description
Secondary malignant neoplasm of respiratory and digestive organs
HCC (V28)
No CMS-HCC V28 mapping
RAF
Billable
No
Payment year
2026

Coder workflow notes

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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)

Child Codes

Code Hierarchy

C78Secondary malignant neoplasm of respiratory and digestive organs
C78Secondary malignant neoplasm of respiratory and digestive organs

More on C78

Related condition guides

Referenced in blog posts

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