C7B.01 maps to CMS-HCC V28 17. A source-labeled RAF reference is available. Confirm the documented diagnosis and applicable coding requirements. MEAT criteria · RAF Calculator · HCC coding software

ICD-10-CM Code View

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Code lookupC7B.01

Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Neoplasms (C00-D49) / Secondary neuroendocrine tumors (C7B)

C7B.01

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

Secondary carcinoid tumors of distant lymph nodes

This code describes cancer that started as a carcinoid tumor (a slow-growing neuroendocrine cancer) in one part of the body and has spread to lymph nodes that are far away from the original tumor site. Carcinoid tumors can occur in various organs like the lungs, stomach, or intestines and may metastasize to distant lymph nodes.

Buddy Insight

Secondary carcinoid tumors of distant lymph nodes indicates that a carcinoid tumor has metastasized to lymph nodes far from the primary site, confirming Stage IV disease.

Overview Risk Models Code Book Documentation Audit Notes Edition comparison

CMS-HCC V28

Mapped

HCC 17

Cancer Metastatic to Lung, Li...

Coefficient HCC 17: 4.209 (Community Non-Dual Aged (CNA))

CMS-HCC V24

Historical

Not used for standard CY2026 Medicare Advantage payment. Select a historical period to review V24.

Not used for CY2026 payment

ACA/HHS

Mapped

HCC 008

HHS-HCC 008 adult, RAF varies...

Code-level coefficient reference

ESRD/PACE

Mapped

HCC 8

Metastatic Cancer and Acute L...

Code-level coefficient reference

RXHCC

Mapped

HCC 20

Lung, Kidney, and Other Cance...

Code-level coefficient reference

Code Book Path

Official

C7BSecondary neuroendocrine tumors C7B.0Secondary carcinoid tumors C7B.01Secondary carcinoid tumors of distant lymph nodes

Inclusion Terms

Official

No inclusion terms are included in this display for C7B.01. Check the code and parent instructions in the Code Book.

Excludes 2

Official

No Excludes 2 notes are included in this display for C7B.01. Check the code and parent instructions in the Code Book.

Related Codes

Official

C7B.00Secondary carcinoid tumors, unspecified site C7B.02Secondary carcinoid tumors of liver C7B.03Secondary carcinoid tumors of bone C7B.04Secondary carcinoid tumors of peritoneum C7B.09Secondary carcinoid tumors of other sites

Includes

Official

No Includes notes are included in this display for C7B.01. Check the code and parent instructions in the Code Book.

Excludes 1

Official

No Excludes 1 notes are included in this display for C7B.01. Check the code and parent instructions in the Code Book.

Code First

Official

No Code First sequencing instructions are included in this display for C7B.01. Check the code and parent instructions in the Code Book.

Use Additional

Official

code to identify any functional activityInherited from C7B

Code Also

Official

No Code Also instructions are included in this display for C7B.01. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance

Documentation confirming distant (not regional) lymph node involvement

Identification of the primary carcinoid tumor site coded separately (C7A codes)

Imaging confirming lymph node metastasis distant from the primary tumor

Biopsy or pathology confirmation of carcinoid histology in the lymph node if available

MEAT Support

HCC Buddy guidance

Documentation confirming distant (not regional) lymph node involvement

Identification of the primary carcinoid tumor site coded separately (C7A codes)

Imaging confirming lymph node metastasis distant from the primary tumor

Biopsy or pathology confirmation of carcinoid histology in the lymph node if available

Audit Caution

HCC Buddy guidance

Coding regional lymph node involvement as distant metastasis — regional nodes are part of primary tumor staging

Failing to code the primary carcinoid tumor site separately

Using generic secondary lymph node neoplasm codes (C77) instead of the carcinoid-specific C7B.01

Not distinguishing sentinel node involvement from truly distant lymph node disease

Common Mistakes

HCC Buddy guidance

C7B.00 — Secondary carcinoid tumors, unspecified site: Use C7B.01 when lymph nodes are specifically documented as the metastatic site

C77.0-C77.9 — Secondary and unspecified malignant neoplasm of lymph nodes: Use C77 codes for non-carcinoid cancer metastatic to lymph nodes; C7B.01 is specific to carcinoid histology

C7A codes with regional lymph node involvement: Regional nodes are staged with the primary tumor, not coded separately as secondary

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 C7B.01 an HCC code?

Yes. C7B.01 (Secondary carcinoid tumors of distant lymph nodes) maps to HCC 17, Cancer Metastatic to Lung, Liver, Brain, and Other Organs; Acute Myeloid Leukemia Except Promyelocytic under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 4.209. 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: C7B.01 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: C7B.01
Description: Secondary carcinoid tumors of distant lymph nodes
HCC (V28): HCC 17 — Cancer Metastatic to Lung, Liver, Brain, and Other Organs; Acute Myeloid Leukemia Except Promyelocytic
RAF reference coefficient: 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

ESRDHCC 8, Metastatic Cancer and Acute Leukemia

Not separately weighted

RxHCCHCC 20, Lung, Kidney, and Other Cancers; Secondary Cancer of Lymph Nodes and Other Sites

Not separately weighted

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 C7B.01 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for C7B.01

For C7B.01, 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

C7B.01 is the ICD-10-CM diagnosis code for secondary carcinoid tumors of distant lymph nodes. This code describes cancer that started as a carcinoid tumor (a slow-growing neuroendocrine cancer) in one part of the body and has spread to lymph nodes that are far away from the original tumor site. Carcinoid tumors can occur in various organs like the lungs, stomach, or intestines and may metastasize to distant lymph nodes. C7B.01 sits in the ICD-10-CM chapter for neoplasms (c00-d49), within the section covering secondary neuroendocrine tumors (c7b).

Under the CMS-HCC V28 risk adjustment model, C7B.01 maps to Cancer Metastatic to Lung, Liver, Brain, and Other Organs; Acute Myeloid Leukemia Except Promyelocytic (HCC 17) with a source-labeled community, non-dual, aged reference coefficient of 4.209. 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.

This is a secondary/metastatic carcinoid tumor code, so you must first identify and code the primary carcinoid tumor site separately before assigning this code. For C7B.01, 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 C7B.01 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•This is a secondary/metastatic carcinoid tumor code, so you must first identify and code the primary carcinoid tumor site separately before assigning this code
•Verify the lymph node location is truly 'distant' (not regional to the primary site) and ensure documentation specifies lymph node involvement rather than other metastatic sites

Clinical Significance

Secondary carcinoid tumors of distant lymph nodes indicates that a carcinoid tumor has metastasized to lymph nodes far from the primary site, confirming Stage IV disease. Distant lymph node metastasis must be distinguished from regional lymph node involvement, which may indicate earlier-stage disease. This finding typically warrants systemic therapy and portends a more guarded prognosis than localized carcinoid.

Documentation Requirements

✓Documentation confirming distant (not regional) lymph node involvement
✓Identification of the primary carcinoid tumor site coded separately (C7A codes)
✓Imaging confirming lymph node metastasis distant from the primary tumor
✓Biopsy or pathology confirmation of carcinoid histology in the lymph node if available
✓Distinction between regional lymph node spread (which may be part of primary staging) and truly distant lymph node metastasis

Commonly Confused Codes

•C7B.00: Secondary carcinoid tumors, unspecified site: Use C7B.01 when lymph nodes are specifically documented as the metastatic site
•C77.0-C77.9: Secondary and unspecified malignant neoplasm of lymph nodes: Use C77 codes for non-carcinoid cancer metastatic to lymph nodes; C7B.01 is specific to carcinoid histology
•C7A codes with regional lymph node involvement: Regional nodes are staged with the primary tumor, not coded separately as secondary