C7A.023 ICD-10-CM Code: Malignant carcinoid tumor of the transverse colon
C7A.023 maps to CMS-HCC V28 21. A source-labeled RAF reference is available. Confirm the documented diagnosis and applicable coding requirements. MEAT criteria · RAF Calculator · HCC coding software
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FY 2026 Apr update / Neoplasms (C00-D49) / Malignant neuroendocrine tumors (C7A)
C7A.023
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceMalignant carcinoid tumor of the transverse colon
A rare type of cancer that starts in hormone-producing cells of the transverse colon (the middle section of the large intestine). This tumor has the potential to spread to other parts of the body.

Buddy Insight
Malignant carcinoid tumor of the transverse colon is a rare neuroendocrine neoplasm in the horizontal segment of the large intestine.
CMS-HCC V28
MappedHCC 21
Coefficient HCC 21: 0.671 (Community Non-Dual Aged (CNA))
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
MappedHCC 012
Code-level coefficient reference
ESRD/PACE
MappedHCC 12
Code-level coefficient reference
RXHCC
MappedHCC 22
Code-level coefficient reference
Code Book Path
Inclusion Terms
OfficialNo inclusion terms are included in this display for C7A.023. Check the code and parent instructions in the Code Book.
Excludes 2
Official- malignant pancreatic islet cell tumors (C25.4)Inherited from C7A
- Merkel cell carcinoma (C4A.-)Inherited from C7A
Related Codes
Includes
OfficialNo Includes notes are included in this display for C7A.023. Check the code and parent instructions in the Code Book.
Excludes 1
OfficialNo Excludes 1 notes are included in this display for C7A.023. Check the code and parent instructions in the Code Book.
Code First
OfficialNo Code First sequencing instructions are included in this display for C7A.023. Check the code and parent instructions in the Code Book.
Use Additional
Official- code to identify any associated endocrine syndrome, such as:Inherited from C7A
- carcinoid syndrome (E34.00)Inherited from C7A
Code Also
Official- any associated multiple endocrine neoplasia [MEN] syndromes (E31.2-)Inherited from C7A
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
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 C7A.023 an HCC code?
Yes. C7A.023 (Malignant carcinoid tumor of the transverse colon) maps to HCC 21, Lymphoma and Other Cancers under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 0.671. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes. It is billable for payment year 2026.
Coder answer: C7A.023 is billable and maps to V28 HCC 21, Lymphoma and Other Cancers. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.
- Code
- C7A.023
- Description
- Malignant carcinoid tumor of the transverse colon
- HCC (V28)
- HCC 21 — Lymphoma and Other Cancers
- RAF reference coefficient
- 0.671
- Billable
- Yes
- Payment year
- 2026
HCC Category Mapping
These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. 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 context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.
Work C7A.023 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →
MEAT review for C7A.023
For C7A.023, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.
- 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
Coder workflow notes
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What This Code Means
C7A.023 is the ICD-10-CM diagnosis code for malignant carcinoid tumor of the transverse colon. A rare type of cancer that starts in hormone-producing cells of the transverse colon (the middle section of the large intestine). This tumor has the potential to spread to other parts of the body. C7A.023 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.023 maps to Lymphoma and Other Cancers (HCC 21) with a source-labeled community, non-dual, aged reference coefficient of 0.671. No V24 mapping is shown for C7A.023; use the applicable model and payment year when reviewing the V28 mapping. For CY2026 non-PACE Medicare Advantage, CMS uses 100% of the 2024 CMS-HCC model (V28). PACE uses a separate model blend. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes.
Verify the specific site is documented as transverse colon; carcinoid tumors of different colon segments have different codes (C7A.021 for cecum, C7A.022 for ascending colon, C7A.024 for descending colon, etc.). For C7A.023, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule. 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, source-labeled coefficient references, and MEAT documentation criteria for C7A.023 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify the specific site is documented as transverse colon; carcinoid tumors of different colon segments have different codes (C7A.021 for cecum, C7A.022 for ascending colon, C7A.024 for descending colon, etc.)
- •This code includes the malignant behavior; do not add a separate malignancy code. Confirm whether metastasis is present and code accordingly with additional codes if documented.
Clinical Significance
Malignant carcinoid tumor of the transverse colon is a rare neuroendocrine neoplasm in the horizontal segment of the large intestine. Transverse colon carcinoids straddle the embryological boundary between midgut and hindgut, which can affect their hormone production profile and clinical behavior. They are typically discovered during colonoscopy or on imaging for abdominal symptoms.
Documentation Requirements
- ✓Pathological confirmation of neuroendocrine tumor with malignant features
- ✓Tumor grade — Ki-67 index and mitotic count
- ✓Tumor size, depth of invasion, and lymphovascular invasion status
- ✓Colonoscopic location confirmed as transverse colon versus hepatic or splenic flexure
- ✓Staging — CT, octreotide scan for metastatic assessment
- ✓Biochemical markers — chromogranin A, 5-HIAA
Commonly Confused Codes
- •C18.4: Primary malignant neoplasm of transverse colon; adenocarcinoma of the transverse colon uses different coding
- •C7A.022: Malignant carcinoid tumor of ascending colon; located proximal to the transverse colon
- •C7A.024: Malignant carcinoid tumor of descending colon; located distal to the transverse colon
- •D3A.023: Benign carcinoid tumor of transverse colon; confirm malignant behavior before coding C7A.023

