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C79.49 ICD-10-CM Code: Secondary malignant neoplasm of other parts of nervous system

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

C79.49

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

Secondary malignant neoplasm of other parts of nervous system

Cancer that has spread to other parts of the nervous system not specified elsewhere, such as the spinal cord or peripheral nerves.

Buddy the Bee presenting code insight

Buddy Insight

Secondary malignant neoplasm of other parts of the nervous system captures metastatic disease to nervous system structures beyond the brain and cerebral meninges, including the spinal cord, spinal meninges, cranial nerves, and peripheral nerves.

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
C79Secondary malignant neoplasm of other and unspecified sites
C79.4Secondary malignant neoplasm of other and unspecified parts of nervous system
C79.49Secondary malignant neoplasm of other parts of nervous system

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for C79.49 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for C79.49 in this effective period.

Related Child Codes

Official
C79.40Secondary malignant neoplasm of unspecified part of nervous system

Includes

Official

ICD-10-CM does not list Includes notes for C79.49 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for C79.49 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for C79.49 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for C79.49 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for C79.49 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
Primary cancer site documented and coded separately
Specific identification of the nervous system structure — spinal cord, spinal meninges, cranial nerves, peripheral nerves
MRI of the spine or affected region confirming metastatic disease
Neurological assessment — motor function, sensation, bowel/bladder function

MEAT Support

HCC Buddy guidance
Primary cancer site documented and coded separately
Specific identification of the nervous system structure — spinal cord, spinal meninges, cranial nerves, peripheral nerves
MRI of the spine or affected region confirming metastatic disease
Neurological assessment — motor function, sensation, bowel/bladder function

Audit Caution

HCC Buddy guidance
Using C79.49 for brain metastases when C79.31 specifically exists
Not recognizing spinal cord compression as a medical emergency requiring additional coding (G95.20)
Confusing primary spinal cord tumors (ependymoma, astrocytoma) with metastatic spinal disease
Failing to code associated neurological deficits separately — paraplegia, neurogenic bladder

Common Mistakes

HCC Buddy guidance
C79.31 — Secondary malignant neoplasm of brain; brain metastases have their own specific code
C79.32 — Secondary malignant neoplasm of cerebral meninges; cerebral meningeal disease is coded separately
C79.40 — Secondary malignant neoplasm of unspecified nervous system; use C79.49 when the specific site is known
C72.0-C72.1 — Primary malignant neoplasm of spinal cord; distinguish primary from metastatic spinal tumors

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 C79.49 an HCC code?

Yes. C79.49 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 C79.49

For C79.49to 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 C79.49 during that encounter, not just copy-forwarded from a problem list.

What This Code Means

C79.49 is the ICD-10-CM diagnosis code for secondary malignant neoplasm of other parts of nervous system. Cancer that has spread to other parts of the nervous system not specified elsewhere, such as the spinal cord or peripheral nerves. C79.49 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, C79.49 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, C79.49 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 is a catch-all code for secondary nervous system malignancies not captured by C79.31 (brain) or C79.32 (meninges); document the specific site when possible. Because C79.49 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 C79.49 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • This is a catch-all code for secondary nervous system malignancies not captured by C79.31 (brain) or C79.32 (meninges); document the specific site when possible
  • Ensure the primary cancer site is coded separately and that more specific nervous system sites have been ruled out

Clinical Significance

Secondary malignant neoplasm of other parts of the nervous system captures metastatic disease to nervous system structures beyond the brain and cerebral meninges, including the spinal cord, spinal meninges, cranial nerves, and peripheral nerves. Spinal cord metastases can cause devastating neurological complications including paralysis and require urgent treatment.

Documentation Requirements

  • Primary cancer site documented and coded separately
  • Specific identification of the nervous system structure — spinal cord, spinal meninges, cranial nerves, peripheral nerves
  • MRI of the spine or affected region confirming metastatic disease
  • Neurological assessment — motor function, sensation, bowel/bladder function
  • Urgency of intervention — spinal cord compression is a medical emergency

Commonly Confused Codes

  • C79.31 — Secondary malignant neoplasm of brain; brain metastases have their own specific code
  • C79.32 — Secondary malignant neoplasm of cerebral meninges; cerebral meningeal disease is coded separately
  • C79.40 — Secondary malignant neoplasm of unspecified nervous system; use C79.49 when the specific site is known
  • C72.0-C72.1 — Primary malignant neoplasm of spinal cord; distinguish primary from metastatic spinal tumors

Child Codes

Code Hierarchy

More on C79.49

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