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C78.89 ICD-10-CM Code: Secondary malignant neoplasm of other digestive organs

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

C78.89

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

Secondary malignant neoplasm of other digestive organs

Cancer that has spread to other specific digestive organs (such as stomach, pancreas, or esophagus) from a primary cancer that started elsewhere.

Buddy the Bee presenting code insight

Buddy Insight

Secondary malignant neoplasm of other digestive organs captures metastatic disease to specific digestive organs not covered by codes C78.

CMS-HCC V28

HCC 17

RAF 4.209

CMS-HCC V24

HCC 8

RAF 2.659

ACA/HHS

HCC 8

Varies by metal level

ESRD/PACE

HCC 8

RAF 0.353

RXHCC

HCC 18

RAF 1.949

Code Book Path

Official
C78Secondary malignant neoplasm of respiratory and digestive organs
C78.8Secondary malignant neoplasm of other and unspecified digestive organs
C78.89Secondary malignant neoplasm of other digestive organs

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for C78.89 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for C78.89 in this effective period.

Related Child Codes

Official
C78.80Secondary malignant neoplasm of unspecified digestive organ

Includes

Official

ICD-10-CM does not list Includes notes for C78.89 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for C78.89 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for C78.89 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for C78.89 in this effective period.

Code Also

Official
  • exocrine pancreatic insufficiency (K86.81)

Buddy Documentation Tip

HCC Buddy guidance
Primary cancer site documented and coded separately
Specific identification of the digestive organ involved — stomach, pancreas, esophagus, gallbladder, etc.
Imaging or pathological confirmation distinguishing metastatic from primary disease
Complications — obstruction, hemorrhage, fistula formation

MEAT Support

HCC Buddy guidance
Primary cancer site documented and coded separately
Specific identification of the digestive organ involved — stomach, pancreas, esophagus, gallbladder, etc.
Imaging or pathological confirmation distinguishing metastatic from primary disease
Complications — obstruction, hemorrhage, fistula formation

Audit Caution

HCC Buddy guidance
Using this code for liver metastases when C78.7 specifically exists
Confusing primary pancreatic or gastric cancer with metastatic disease to these organs
Not verifying through pathology that the histology of the digestive organ tumor matches the known primary site
Failing to code digestive system complications (obstruction, bleeding) separately

Common Mistakes

HCC Buddy guidance
C78.80 — Secondary malignant neoplasm of unspecified digestive organ; use C78.89 when the specific organ IS known
C78.7 — Secondary malignant neoplasm of liver; liver metastases have a dedicated code
C25.0-C25.9 — Primary malignant neoplasm of pancreas; verify the pancreatic involvement is secondary, not primary
C16.0-C16.9 — Primary malignant neoplasm of stomach; differentiate primary gastric cancer from metastatic disease to the stomach

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 C78.89 an HCC code?

Yes. C78.89 (Secondary malignant neoplasm of other digestive organs) maps to Cancer Metastatic to Lung, Liver, Brain, and Other Organs; Acute Myeloid Leukemia Except Promyelocytic under the CMS-HCC V28 risk adjustment model (and Metastatic Cancer and Acute Leukemia under V24), with a community non-dual aged RAF of 4.209. It is billable for payment year 2026.

Coder answer: C78.89 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
C78.89
Description
Secondary malignant neoplasm of other digestive organs
HCC (V28)
HCC 17 — Cancer Metastatic to Lung, Liver, Brain, and Other Organs; Acute Myeloid Leukemia Except Promyelocytic
RAF
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
V24HCC 8, Metastatic Cancer and Acute Leukemia
2.659
ESRDHCC 8, Metastatic Cancer and Acute Leukemia
0.353
RxHCCHCC 18, Metastatic Cancer to Lung and Other Respiratory Sites
1.949

Each model's RAF is its CMS base weight for that model's standard population, so 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 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.

Work C78.89 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for C78.89

For C78.89 to 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 C78.89 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

C78.89 is the ICD-10-CM diagnosis code for secondary malignant neoplasm of other digestive organs. Cancer that has spread to other specific digestive organs (such as stomach, pancreas, or esophagus) from a primary cancer that started elsewhere. C78.89 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, C78.89 maps to Cancer Metastatic to Lung, Liver, Brain, and Other Organs; Acute Myeloid Leukemia Except Promyelocytic (HCC 17) with a community, non-dual, aged base RAF weight of 4.209. Under the older CMS-HCC V24 model, C78.89 maps to Metastatic Cancer and Acute Leukemia (HCC 8) with a community, non-dual, aged base RAF weight of 2.659. 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 covers digestive organs not included in C78.4, C78.5, C78.7, or C78.80; review documentation for the specific organ. Because C78.89 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 C78.89 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • •This code covers digestive organs not included in C78.4, C78.5, C78.7, or C78.80; review documentation for the specific organ
  • •Always establish the primary cancer site and code it separately to show the metastatic relationship

Clinical Significance

Secondary malignant neoplasm of other digestive organs captures metastatic disease to specific digestive organs not covered by codes C78.4 through C78.7, such as the stomach, pancreas, esophagus, or gallbladder. These metastatic sites can significantly affect nutrition, digestion, and quality of life, requiring specialized management approaches.

Documentation Requirements

  • ✓Primary cancer site documented and coded separately
  • ✓Specific identification of the digestive organ involved — stomach, pancreas, esophagus, gallbladder, etc.
  • ✓Imaging or pathological confirmation distinguishing metastatic from primary disease
  • ✓Complications — obstruction, hemorrhage, fistula formation
  • ✓Treatment approach and intent — curative versus palliative

Code Also

  • exocrine pancreatic insufficiency (K86.81)

Commonly Confused Codes

  • •C78.80: Secondary malignant neoplasm of unspecified digestive organ; use C78.89 when the specific organ IS known
  • •C78.7: Secondary malignant neoplasm of liver; liver metastases have a dedicated code
  • •C25.0-C25.9: Primary malignant neoplasm of pancreas; verify the pancreatic involvement is secondary, not primary
  • •C16.0-C16.9: Primary malignant neoplasm of stomach; differentiate primary gastric cancer from metastatic disease to the stomach

Child Codes

C78.80Secondary malignant neoplasm of unspecified digestive organ
HCC 17
C78.89Secondary malignant neoplasm of other digestive organs
HCC 17

Code Hierarchy

└C78Secondary malignant neoplasm of respiratory and digestive organs└C78.8Secondary malignant neoplasm of other and unspecified digestive organs└C78.89Secondary malignant neoplasm of other digestive organs
└C78.89Secondary malignant neoplasm of other digestive organs

Because C78.89 maps to a payment HCC, the documentation must also satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's risk adjustment score.

C78.89 maps to CMS-HCC V28 category 17, Cancer Metastatic to Lung, Liver, Brain, and Other Organs; Acute Myeloid Leukemia Except Promyelocytic. See the ICD-10 to HCC mapping hub for how the V28 crosswalk works. Because C78.89 carries a payment HCC, you can see what it adds to a RAF score and check the documentation the chart needs before it is submitted.

More on C78.89

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