C7B.01
BillableSecondary carcinoid tumors of distant lymph nodes
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is C7B.01 an HCC code?
Yes. C7B.01 maps to Cancer Metastatic to Lung, Liver, Brain, and Other Organs; Acute Myeloid Leukemia Except Promyelocytic 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 C7B.01
For C7B.01to 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 C7B.01 during that encounter — not just copy-forwarded from a problem list.
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 community, non-dual, aged base RAF weight of 4.209. Under the older CMS-HCC V24 model, C7B.01 maps to Metastatic Cancer and Acute Leukemia (HCC 8) with a community, non-dual, aged base RAF weight of 2.659. 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 secondary/metastatic carcinoid tumor code, so you must first identify and code the primary carcinoid tumor site separately before assigning this code. Because C7B.01 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 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