C78.7 ICD-10-CM Code: Secondary malignant neoplasm of liver and intrahepatic bile duct
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)
C78.7
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceSecondary 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.
CMS-HCC V28
MappedHCC 17
RAF 0.368
CMS-HCC V24
MappedHCC 8
RAF 2.484
ACA/HHS
00
RAF 0
ESRD/PACE
MappedHCC 8
RAF 0.0
RXHCC
MappedHCC 18
RAF 0.0
Code Trumping
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Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for C78.7 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 C78.7 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 C78.7 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for C78.7 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for C78.7 in this effective period.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
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 C78.7 an HCC code?
Yes. C78.7 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
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 C78.7
For C78.7to 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 C78.7 during that encounter, not just copy-forwarded from a problem list.
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 Metastatic Cancer and Acute Leukemia (HCC 17) with a community, non-dual, aged base RAF weight of 0.368. Under the older V24 model, C78.7 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.
The liver is a common site for metastatic disease; always code the primary cancer site separately. Because C78.7 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 C78.7 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