Is ICD-10-CM code C25 billable?

No, C25 (Malignant neoplasm of pancreas) 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 C25 belong to?

C25 belongs to Chapter 2 of the ICD-10-CM tabular list: C00–D49 (Neoplasms).

C25Not billable, use a more specific code below

Malignant neoplasm of pancreas

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

8 billable codes under C25: 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

Code also: add a code for this too, order depends on the encounter

if applicable exocrine pancreatic insufficiency (K86.81)

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 C25.

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 C25

C25 can't be used on a claim. Pick a billable code below; grey headings group them.

C25 MS-DRGs

As the principal diagnosis, all 8 billable codes under C25 group to MS-DRG 435, 436, or 437 (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 C25

Notes on these codes point to C25.

Z85.07 Includes: Conditions classifiable to C25

About the condition

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

Pancreatic Cancer

The pancreas is a gland behind your stomach and in front of your spine. It produces the juices that help break down food and the hormones that help control blood sugar levels. Pancreatic cancer usually begins in the cells that produce the juices. Some risk factors for developing pancreatic cancer include:

Code history

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