What is ICD-10 code C78.7?

C78.7 is the ICD-10-CM diagnosis code for Secondary malignant neoplasm of liver and intrahepatic bile duct. Cancer that has spread to the liver or bile ducts within the liver from a primary cancer located elsewhere in the body. It belongs to the ICD-10-CM chapter for neoplasms (c00-d49). C78.7 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. C78.7 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. C78.7 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. C78.7 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 C78.7 map to under V28?

C78.7 maps to CMS-HCC V28 HCC 17 (Cancer Metastatic to Lung, Liver, Brain, and Other Organs; Acute Myeloid Leukemia Except Promyelocytic). The category numbers, labels, and conditions come from the CMS-HCC V28 model file for payment year 2026.

2026 ICD-10-CM C78.7: Secondary malignant neoplasm

C78.7 maps to CMS-HCC V28 17. 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 lookupC78.7

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)

C78.7

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

Secondary malignant neoplasm of liver and intrahepatic bile duct

Cancer that has spread to the liver or bile ducts within the liver from a primary cancer located elsewhere in the body.

Buddy Insight

Secondary malignant neoplasm of the liver and intrahepatic bile duct is one of the most common metastatic sites across all cancer types.

Overview Risk Models Code Book Documentation Audit Notes Edition comparison

CMS-HCC V28

Mapped

HCC 17

Cancer Metastatic to Lung, Li...

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 008

HHS-HCC 008 adult, RAF varies...

Code-level coefficient reference

ESRD/PACE

Mapped

HCC 8

Metastatic Cancer and Acute L...

Code-level coefficient reference

RXHCC

Mapped

HCC 18

Secondary Cancer of Lung, Liv...

Code-level coefficient reference

Code Book Path

Official

C78Secondary malignant neoplasm of respiratory and digestive organs C78.7Secondary malignant neoplasm of liver and intrahepatic bile duct

Inclusion Terms

Official

No inclusion terms are included in this display for C78.7. Check the code and parent instructions in the Code Book.

Excludes 2

Official

lymph node metastases (C77.0)Inherited from C78

Related 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

No Includes notes are included in this display for C78.7. Check the code and parent instructions in the Code Book.

Excludes 1

Official

secondary carcinoid tumors of liver (C7B.02)Inherited from C78
secondary carcinoid tumors of peritoneum (C7B.04)Inherited from C78

Code First

Official

No Code First sequencing instructions are included in this display for C78.7. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for C78.7. Check the code and parent instructions in the Code Book.

Code Also

Official

No Code Also instructions are included in this display for C78.7. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance

Primary cancer site must be identified and coded separately

Imaging confirmation — CT, MRI, or PET showing hepatic lesions consistent with metastatic disease

Number and size of liver metastases — solitary versus multiple, unilobar versus bilobar

Liver function impact — elevated liver enzymes, bilirubin, synthetic function

MEAT Support

HCC Buddy guidance

Primary cancer site must be identified and coded separately

Imaging confirmation — CT, MRI, or PET showing hepatic lesions consistent with metastatic disease

Number and size of liver metastases — solitary versus multiple, unilobar versus bilobar

Liver function impact — elevated liver enzymes, bilirubin, synthetic function

Audit Caution

HCC Buddy guidance

Confusing primary hepatocellular carcinoma (C22.0) with liver metastases (C78.7) — pathology and clinical context are essential

Failing to code the primary cancer site when liver metastases are present

Not recognizing that a patient with a history of hepatitis or cirrhosis can have BOTH primary liver cancer and metastatic disease

Using C78.7 for gallbladder metastases — gallbladder is not intrahepatic

Common Mistakes

HCC Buddy guidance

C22.0 — Hepatocellular carcinoma (primary liver cancer); must distinguish primary from secondary liver malignancy

C22.1 — Intrahepatic bile duct carcinoma (cholangiocarcinoma); this is primary, not metastatic

C78.89 — Secondary malignant neoplasm of other digestive organs; liver metastases have their own specific code

K76.89 — Other specified diseases of liver; non-malignant liver conditions should not be confused with metastatic disease

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 C78.7 an HCC code?

Yes. C78.7 (Secondary malignant neoplasm of liver and intrahepatic bile duct) maps to HCC 17, Cancer Metastatic to Lung, Liver, Brain, and Other Organs; Acute Myeloid Leukemia Except Promyelocytic under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 4.209. 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: C78.7 is billable and maps to V28 HCC 17, Cancer Metastatic to Lung, Liver, Brain, and Other Organs; Acute Myeloid Leukemia Except Promyelocytic. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code: C78.7
Description: Secondary malignant neoplasm of liver and intrahepatic bile duct
HCC (V28): HCC 17 — Cancer Metastatic to Lung, Liver, Brain, and Other Organs; Acute Myeloid Leukemia Except Promyelocytic
RAF reference coefficient: 4.209
Billable: Yes
Payment year: 2026

HCC Category Mapping

V28HCC 17, Cancer Metastatic to Lung, Liver, Brain, and Other Organs; Acute Myeloid Leukemia Except Promyelocytic

4.209

ESRDHCC 8, Metastatic Cancer and Acute Leukemia

Not separately weighted

RxHCCHCC 18, Secondary Cancer of Lung, Liver, Brain, and Other Sites

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 C78.7 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for C78.7

For C78.7, 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

C78.7 is the ICD-10-CM diagnosis code for secondary malignant neoplasm of liver and intrahepatic bile duct. Cancer that has spread to the liver or bile ducts within the liver from a primary cancer located elsewhere in the body. C78.7 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, C78.7 maps to Cancer Metastatic to Lung, Liver, Brain, and Other Organs; Acute Myeloid Leukemia Except Promyelocytic (HCC 17) with a source-labeled community, non-dual, aged reference coefficient of 4.209. No V24 mapping is shown for C78.7; 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.

The liver is a common site for metastatic disease; always code the primary cancer site separately. For C78.7, 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 C78.7 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•The liver is a common site for metastatic disease; always code the primary cancer site separately
•Distinguish from primary liver cancer (C22.x codes) by confirming the cancer originated in another organ

Clinical Significance

Secondary malignant neoplasm of the liver and intrahepatic bile duct is one of the most common metastatic sites across all cancer types. The liver is a frequent site of distant spread for colorectal, breast, lung, and pancreatic cancers due to its dual blood supply. Hepatic metastases significantly affect prognosis, treatment options, and survival, and represent a major driver of resource utilization.

Documentation Requirements

✓Primary cancer site must be identified and coded separately
✓Imaging confirmation — CT, MRI, or PET showing hepatic lesions consistent with metastatic disease
✓Number and size of liver metastases — solitary versus multiple, unilobar versus bilobar
✓Liver function impact — elevated liver enzymes, bilirubin, synthetic function
✓Treatment approach — surgical resection candidacy, ablation, chemoembolization, systemic therapy

Commonly Confused Codes

•C22.0: Hepatocellular carcinoma (primary liver cancer); must distinguish primary from secondary liver malignancy
•C22.1: Intrahepatic bile duct carcinoma (cholangiocarcinoma); this is primary, not metastatic
•C78.89: Secondary malignant neoplasm of other digestive organs; liver metastases have their own specific code
•K76.89: Other specified diseases of liver; non-malignant liver conditions should not be confused with metastatic disease