C79.19
BillableSecondary malignant neoplasm of other urinary organs
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is C79.19 an HCC code?
Yes. C79.19 maps to Metastatic Cancer to Peritoneum and Other Specified Sites 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 C79.19
For C79.19 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 C79.19 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
C79.19 is the ICD-10-CM diagnosis code for secondary malignant neoplasm of other urinary organs. This code describes cancer that has spread to urinary organs other than the bladder, such as the ureters or urethra. It indicates the cancer originated elsewhere in the body and metastasized to these urinary structures. C79.19 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, C79.19 maps to Metastatic Cancer to Peritoneum and Other Specified Sites (HCC 18) with a community, non-dual, aged base RAF weight of 0.368. Under the older CMS-HCC V24 model, C79.19 maps to Metastatic Cancer and Acute Leukemia (HCC 8) with a community, non-dual, aged base RAF weight of 2.484. 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.
Always code the primary malignancy first, then use C79.19 as a secondary diagnosis to show the cancer has spread to other urinary organs. Because C79.19 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 C79.19 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Always code the primary malignancy first, then use C79.19 as a secondary diagnosis to show the cancer has spread to other urinary organs
- •Do not use this code for primary cancers of the urinary organs; verify documentation clearly states the cancer is secondary/metastatic before assigning this code
Clinical Significance
Secondary malignant neoplasm of other urinary organs captures metastatic disease to urinary structures beyond the kidneys and bladder, such as the ureters or urethra. These are uncommon metastatic sites that may cause urinary obstruction and require specialized urological management. The rarity of these metastases makes careful pathological confirmation essential.
Documentation Requirements
- ✓Primary cancer site documented and coded separately
- ✓Specific identification of the urinary organ involved — ureter, urethra, or other
- ✓Imaging or pathological confirmation of metastatic disease
- ✓Assessment for urinary obstruction or other complications
- ✓Laterality if applicable (right or left ureter)
Commonly Confused Codes
- •C79.00-C79.02 — Secondary malignant neoplasm of kidney; kidney metastases have their own specific codes
- •C79.11 — Secondary malignant neoplasm of bladder; bladder has its own code
- •C79.10 — Secondary malignant neoplasm of unspecified urinary organs; use C79.19 when the specific organ IS known
- •C66.1/C66.2 — Primary malignant neoplasm of ureter; distinguish primary from secondary ureteral cancer