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C78.01 ICD-10-CM Code: Secondary malignant neoplasm of right lung

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

C78.01

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

Secondary malignant neoplasm of right lung

Cancer that has spread to the tissue of the right lung from a cancer that originated elsewhere in the body.

Buddy the Bee presenting code insight

Buddy Insight

Secondary malignant neoplasm of the right lung confirms metastatic disease with specific laterality documentation.

CMS-HCC V28

HCC 17

RAF 0.368

CMS-HCC V24

HCC 8

RAF 2.484

ACA/HHS

0

0

RAF 0

ESRD/PACE

HCC 8

RAF 0.0

RXHCC

HCC 18

RAF 0.0

Code Trumping

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Code Book Path

Official
C78Secondary malignant neoplasm of respiratory and digestive organs
C78.0Secondary malignant neoplasm of lung
C78.01Secondary malignant neoplasm of right lung

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for C78.01 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for C78.01 in this effective period.

Related Child Codes

Official
C78.00Secondary malignant neoplasm of unspecified lung
C78.02Secondary malignant neoplasm of left lung

Includes

Official

ICD-10-CM does not list Includes notes for C78.01 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for C78.01 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for C78.01 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for C78.01 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for C78.01 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
Primary cancer site must be identified and coded separately
Confirmation that the right lung is the metastatic site, not the primary cancer location
Imaging confirmation (CT, PET, MRI) or pathological/biopsy confirmation
Number, size, and location of metastatic lesions within the right lung

MEAT Support

HCC Buddy guidance
Primary cancer site must be identified and coded separately
Confirmation that the right lung is the metastatic site, not the primary cancer location
Imaging confirmation (CT, PET, MRI) or pathological/biopsy confirmation
Number, size, and location of metastatic lesions within the right lung

Audit Caution

HCC Buddy guidance
Defaulting to unspecified lung (C78.00) when documentation clearly states right lung involvement
Coding a primary right lung cancer as secondary when there is no documented primary elsewhere
Confusing right lung parenchymal metastases with right pleural involvement
Missing bilateral disease — if both lungs are involved, code both C78.01 and C78.02

Common Mistakes

HCC Buddy guidance
C34.11 — Primary malignant neoplasm of upper lobe, right bronchus or lung; this is primary lung cancer, not metastatic
C78.00 — Secondary malignant neoplasm of unspecified lung; use C78.01 when right side is documented
C78.02 — Secondary malignant neoplasm of left lung; verify laterality carefully
C78.2 — Secondary malignant neoplasm of pleura; right pleural disease is distinct from right lung parenchymal disease

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.

Is C78.01 an HCC code?

Yes. C78.01 maps to Metastatic Cancer and Acute Leukemia under the CMS-HCC V28 risk adjustment model (and Metastatic Cancer and Acute Leukemia under V24).

HCC Category Mapping

V28HCC 17, Metastatic Cancer and Acute Leukemia
0.368
V24HCC 8, Metastatic Cancer and Acute Leukemia
2.484
ESRDHCC 8, Metastatic Cancer and Acute Leukemia
0.000
RxHCCHCC 18, Metastatic Cancer to Lung and Other Respiratory Sites
0.000

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 C78.01

For C78.01to 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 C78.01 during that encounter, not just copy-forwarded from a problem list.

What This Code Means

C78.01 is the ICD-10-CM diagnosis code for secondary malignant neoplasm of right lung. Cancer that has spread to the tissue of the right lung from a cancer that originated elsewhere in the body. C78.01 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, C78.01 maps to Metastatic Cancer and Acute Leukemia (HCC 17) with a community, non-dual, aged base RAF weight of 0.368. Under the older V24 model, C78.01 mapped to the same category but with a base RAF weight of 2.484, V28 recalibrated weights across the entire model. 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 code is specific to right lung involvement; ensure documentation clearly indicates right-sided disease before coding. Because C78.01 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 C78.01 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • This code is specific to right lung involvement; ensure documentation clearly indicates right-sided disease before coding
  • Code the primary malignancy separately; this represents metastatic disease to the right lung

Clinical Significance

Secondary malignant neoplasm of the right lung confirms metastatic disease with specific laterality documentation. Right lung metastases are clinically significant as they affect treatment planning including potential surgical resection, radiation field planning, and systemic therapy decisions. Documenting laterality reflects higher-quality clinical data.

Documentation Requirements

  • Primary cancer site must be identified and coded separately
  • Confirmation that the right lung is the metastatic site, not the primary cancer location
  • Imaging confirmation (CT, PET, MRI) or pathological/biopsy confirmation
  • Number, size, and location of metastatic lesions within the right lung
  • Current treatment status — active treatment, surveillance, or palliative care

Commonly Confused Codes

  • C34.11 — Primary malignant neoplasm of upper lobe, right bronchus or lung; this is primary lung cancer, not metastatic
  • C78.00 — Secondary malignant neoplasm of unspecified lung; use C78.01 when right side is documented
  • C78.02 — Secondary malignant neoplasm of left lung; verify laterality carefully
  • C78.2 — Secondary malignant neoplasm of pleura; right pleural disease is distinct from right lung parenchymal disease

Child Codes

Code Hierarchy

More on C78.01

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