C7B.09
BillableSecondary carcinoid tumors of other sites
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is C7B.09 an HCC code?
Yes. C7B.09 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.09
For C7B.09to 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.09 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
C7B.09 is the ICD-10-CM diagnosis code for secondary carcinoid tumors of other sites. This code describes cancer that has spread to various parts of the body from a carcinoid tumor (a slow-growing neuroendocrine cancer) that originated elsewhere. Carcinoid tumors produce hormones that can cause specific symptoms like flushing and diarrhea. C7B.09 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.09 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.09 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.
Use this code only for metastatic carcinoid tumors at sites other than the appendix, ileum, lung, thymus, stomach, or kidney—those have their own specific codes. Because C7B.09 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.09 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use this code only for metastatic carcinoid tumors at sites other than the appendix, ileum, lung, thymus, stomach, or kidney—those have their own specific codes
- •Always code the primary carcinoid tumor site first, then use C7B.09 as a secondary diagnosis to indicate spread to other locations
Clinical Significance
Secondary carcinoid tumors of other sites represents metastatic carcinoid disease at locations not captured by the specific C7B codes (liver, bone, lymph nodes, peritoneum). This includes metastases to the brain, skin, adrenal glands, ovaries, or other uncommon sites. Any metastatic carcinoid spread significantly impacts prognosis and treatment intensity, warranting systemic therapy and specialized multidisciplinary management.
Documentation Requirements
- ✓Documentation confirming metastatic carcinoid at the specified site
- ✓Primary carcinoid tumor site documented and coded separately
- ✓Specific metastatic site documented clearly in the medical record
- ✓Confirmation that the site does not fit C7B.01-C7B.04 (lymph nodes, liver, bone, peritoneum)
- ✓Imaging or pathology confirming carcinoid histology at the metastatic site
- ✓Treatment plan for the metastatic disease
Commonly Confused Codes
- •C7B.01-C7B.04 — Site-specific secondary carcinoid codes: Use these when the metastatic site is lymph nodes, liver, bone, or peritoneum
- •C7B.00 — Secondary carcinoid tumors, unspecified site: Use when the metastatic site is unknown; C7B.09 is for a known but non-standard site
- •C79 series — Secondary malignant neoplasm of other specified sites: Use for non-carcinoid metastatic cancers