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C7A.022 ICD-10-CM Code: Malignant carcinoid tumor of the ascending colon

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FY 2026 Apr update / Neoplasms (C00-D49) / Malignant neuroendocrine tumors (C7A)

C7A.022

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

Malignant carcinoid tumor of the ascending colon

A rare cancer that develops in hormone-producing cells of the ascending colon, the first upward section of the large intestine on the right side of the abdomen.

Buddy the Bee presenting code insight

Buddy Insight

Malignant carcinoid tumor of the ascending colon is a rare neuroendocrine neoplasm of the right colon.

CMS-HCC V28

HCC 21

RAF 0.545

CMS-HCC V24

HCC 12

RAF 0.150

ACA/HHS

0

0

RAF 0

ESRD/PACE

HCC 12

RAF 0.0

RXHCC

HCC 22

RAF 0.0

Code Trumping

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Code Book Path

Official
C7A.0Malignant carcinoid tumors
C7A.02Malignant carcinoid tumors of the appendix, large intestine, and rectum
C7A.022Malignant carcinoid tumor of the ascending colon

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for C7A.022 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for C7A.022 in this effective period.

Related Child Codes

Official
C7A.020Malignant carcinoid tumor of the appendix
C7A.021Malignant carcinoid tumor of the cecum
C7A.023Malignant carcinoid tumor of the transverse colon
C7A.024Malignant carcinoid tumor of the descending colon
C7A.025Malignant carcinoid tumor of the sigmoid colon

Includes

Official

ICD-10-CM does not list Includes notes for C7A.022 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for C7A.022 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for C7A.022 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for C7A.022 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for C7A.022 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
Pathological confirmation with immunohistochemistry (synaptophysin, chromogranin A)
Tumor size and depth of invasion — transmural involvement increases metastatic risk
Ki-67 index and mitotic rate for WHO grading
Colonoscopic and imaging findings confirming ascending colon location

MEAT Support

HCC Buddy guidance
Pathological confirmation with immunohistochemistry (synaptophysin, chromogranin A)
Tumor size and depth of invasion — transmural involvement increases metastatic risk
Ki-67 index and mitotic rate for WHO grading
Colonoscopic and imaging findings confirming ascending colon location

Audit Caution

HCC Buddy guidance
Confusing ascending colon adenocarcinoma with carcinoid tumor — immunohistochemistry helps differentiate
Coding a cecal carcinoid as ascending colon or vice versa — exact location matters
Not grading the tumor to determine benign (D3A) versus malignant (C7A) classification
Failing to check for carcinoid syndrome symptoms and code E34.0 separately when present

Common Mistakes

HCC Buddy guidance
C18.2 — Primary malignant neoplasm of ascending colon; adenocarcinoma uses C18 codes
C7A.021 — Malignant carcinoid tumor of cecum; the cecum is proximal to the ascending colon
C7A.023 — Malignant carcinoid tumor of transverse colon; the ascending colon is the right-sided vertical segment
D3A.022 — Benign carcinoid tumor of ascending colon; verify malignant behavior pathologically

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 C7A.022 an HCC code?

Yes. C7A.022 maps to Breast, Prostate, Colorectal and Other Cancers and Tumors under the CMS-HCC V28 risk adjustment model (and Breast, Prostate, and Other Cancers and Tumors under V24).

HCC Category Mapping

V28HCC 21, Breast, Prostate, Colorectal and Other Cancers and Tumors
0.545
V24HCC 12, Breast, Prostate, and Other Cancers and Tumors
0.150
ESRDHCC 12, Breast, Prostate, and Other Cancers and Tumors
0.000
RxHCCHCC 22, Cancer, Other Specified 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 C7A.022

For C7A.022to 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 C7A.022 during that encounter, not just copy-forwarded from a problem list.

What This Code Means

C7A.022 is the ICD-10-CM diagnosis code for malignant carcinoid tumor of the ascending colon. A rare cancer that develops in hormone-producing cells of the ascending colon, the first upward section of the large intestine on the right side of the abdomen. C7A.022 sits in the ICD-10-CM chapter for neoplasms (c00-d49), within the section covering malignant neuroendocrine tumors (c7a).

Under the CMS-HCC V28 risk adjustment model, C7A.022 maps to Breast, Prostate, Colorectal and Other Cancers and Tumors (HCC 21) with a community, non-dual, aged base RAF weight of 0.545. Under the older CMS-HCC V24 model, C7A.022 maps to Breast, Prostate, and Other Cancers and Tumors (HCC 12) with a community, non-dual, aged base RAF weight of 0.150. 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 ascending colon runs vertically up the right side of the abdomen; distinguish from transverse and descending portions. Because C7A.022 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 C7A.022 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • The ascending colon runs vertically up the right side of the abdomen; distinguish from transverse and descending portions
  • Colonic carcinoid tumors may present with abdominal symptoms or be found incidentally during colonoscopy

Clinical Significance

Malignant carcinoid tumor of the ascending colon is a rare neuroendocrine neoplasm of the right colon. Ascending colon carcinoids are part of the midgut neuroendocrine tumor family and may produce serotonin, potentially causing carcinoid syndrome when liver metastases are present. They tend to be diagnosed at a larger size compared to appendiceal carcinoids and carry a more guarded prognosis.

Documentation Requirements

  • Pathological confirmation with immunohistochemistry (synaptophysin, chromogranin A)
  • Tumor size and depth of invasion — transmural involvement increases metastatic risk
  • Ki-67 index and mitotic rate for WHO grading
  • Colonoscopic and imaging findings confirming ascending colon location
  • Staging workup — CT, octreotide scan, liver assessment
  • Surgical procedure performed and margin status

Commonly Confused Codes

  • C18.2 — Primary malignant neoplasm of ascending colon; adenocarcinoma uses C18 codes
  • C7A.021 — Malignant carcinoid tumor of cecum; the cecum is proximal to the ascending colon
  • C7A.023 — Malignant carcinoid tumor of transverse colon; the ascending colon is the right-sided vertical segment
  • D3A.022 — Benign carcinoid tumor of ascending colon; verify malignant behavior pathologically

Child Codes

Code Hierarchy

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