Is ICD-10-CM code C16 billable?

No, C16 (Malignant neoplasm of stomach) is a non-billable ICD-10-CM code. It must be coded to a more specific subcategory before it can be used for reimbursement.

What chapter does ICD-10-CM code C16 belong to?

C16 belongs to Chapter 2 of the ICD-10-CM tabular list: C00–D49 (Neoplasms).

C16Not billable, use a more specific code below

Malignant neoplasm of stomach

In Malignant neoplasms of digestive organs (C15-C26), chapter 2: Neoplasms

9 billable codes under C16: all are a CC; all map to HCC 20 (Lung and Other Severe Cancers).A CC or MCC (major CC) is a secondary diagnosis that raises the MS-DRG payment. An HCC counts toward a Medicare Advantage patient's risk score.

Instructional notes

Excludes2: not included here, code separately if applicable

malignant carcinoid tumor of the stomach (C7A.092)

Use additional code: add a second code for this, listed after this one

code to identify:
alcohol abuse and dependence (F10.-)

Also applies, from Malignant neoplasms of digestive organs (C15-C26)

These notes sit on C15-C26 and apply to every code under it, including C16.

Excludes1: not coded here, use a different code

Kaposi's sarcoma of gastrointestinal sites (C46.4)

Excludes2: not included here, code separately if applicable

gastrointestinal stromal tumors (C49.A-)

Official coding guidelines

From the ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027 (CMS and NCHS). Links open the PDF at the right page.

Rules for coding benign and malignant neoplasms: using the Neoplasm Table, sequencing primary and secondary sites, treatment encounters, complications, and current cancer versus personal history.

Admission/Encounter for treatment of primary site (page 33)
Admission/Encounter for treatment of secondary site (page 33)
Coding and sequencing of complications (page 34)
Primary malignancy previously excised (page 34)
Admissions/Encounters involving antineoplastic chemotherapy, immunotherapy and radiation therapy (page 35)
Admission/encounter to determine extent of malignancy (page 36)
Symptoms, signs, and abnormal findings listed in Chapter 18 associated with neoplasms (page 36)
Admission/encounter for pain control/management (page 36)

Read Section I.C.2 (page 32), 12 more topics

All codes under C16

C16 can't be used on a claim. Pick a billable code below; grey headings group them.

C16 MS-DRGs

As the principal diagnosis, all 9 billable codes under C16 group to MS-DRG 374, 375, or 376 (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.

Other codes that refer to C16

Notes on these codes point to C16.

Z85.028 Includes: Conditions classifiable to C16

About the condition

Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.

Stomach Cancer

The stomach is an organ between the esophagus and the small intestine. It mixes food with stomach acid and helps digest protein. Stomach cancer mostly affects older people - two-thirds of people who have it are over age 65. Your risk of getting it is also higher if you:

Code history

Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.