Malignant neoplasm of bone and articular cartilage of limbs
In Malignant neoplasms of bone and articular cartilage (C40-C41), chapter 2: Neoplasms
18 billable codes under C40: all are a CC; all map to HCC 21 (Lymphoma and Other 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.
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Instructional notes
Use additional code: add a second code for this, listed after this one
- code to identify major osseous defect, if applicable (M89.7-)
Also applies, from Malignant neoplasms of bone and articular cartilage (C40-C41)
These notes sit on C40-C41 and apply to every code under it, including C40.
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)
All codes under C40
C40 can't be used on a claim. Pick a billable code below; grey headings group them.
- C40.0Malignant neoplasm of scapula and long bones of upper limb
- C40.00Malignant neoplasm of scapula and long bones of unspecified upper limb
- C40.01Malignant neoplasm of scapula and long bones of right upper limb
- C40.02Malignant neoplasm of scapula and long bones of left upper limb
- C40.1Malignant neoplasm of short bones of upper limb
- C40.10Malignant neoplasm of short bones of unspecified upper limb
- C40.11Malignant neoplasm of short bones of right upper limb
- C40.12Malignant neoplasm of short bones of left upper limb
- C40.2Malignant neoplasm of long bones of lower limb
- C40.20Malignant neoplasm of long bones of unspecified lower limb
- C40.21Malignant neoplasm of long bones of right lower limb
- C40.22Malignant neoplasm of long bones of left lower limb
- C40.3Malignant neoplasm of short bones of lower limb
- C40.30Malignant neoplasm of short bones of unspecified lower limb
- C40.31Malignant neoplasm of short bones of right lower limb
- C40.32Malignant neoplasm of short bones of left lower limb
- C40.8Malignant neoplasm of overlapping sites of bone and articular cartilage of limb
- C40.80Malignant neoplasm of overlapping sites of bone and articular cartilage of unspecified limb
- C40.81Malignant neoplasm of overlapping sites of bone and articular cartilage of right limb
- C40.82Malignant neoplasm of overlapping sites of bone and articular cartilage of left limb
- C40.9Malignant neoplasm of unspecified bones and articular cartilage of limb
- C40.90Malignant neoplasm of unspecified bones and articular cartilage of unspecified limb
- C40.91Malignant neoplasm of unspecified bones and articular cartilage of right limb
- C40.92Malignant neoplasm of unspecified bones and articular cartilage of left limb
C40 MS-DRGs
As the principal diagnosis, all 18 billable codes under C40 group to MS-DRG 542, 543, or 544 (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 C40
Notes on these codes point to C40.
- C41 Excludes1: malignant neoplasm of bones of limbs (C40.-)
- C41 Excludes1: malignant neoplasm of cartilage of limbs (C40.-)
- C49 Excludes1: articular (C40-C41)
- M89.7 Code First: malignant neoplasm of bone (C40.-)
- M90.6 Code First: the neoplasm (C40.-, C41.-)
- Z80.8 Includes: Conditions classifiable to C00-C14, C40-C49, C69-C79
- Z85.8 Includes: Conditions classifiable to C00-C14, C40-C49, C69-C75, C7A.098, C76-C79
- Z85.83 Includes: Conditions classifiable to C40-C41; C45-C49
About the condition
Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.
Bone Cancer
Cancer that starts in a bone is uncommon. Cancer that has spread to the bone from another part of the body is more common. There are three types of bone cancer:
Read more about bone cancer on MedlinePlusCode history
Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.