Is ICD-10-CM code C78 billable?

No, C78 (Secondary malignant neoplasm of respiratory and digestive organs) 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 C78 belong to?

C78 belongs to Chapter 2 of the ICD-10-CM tabular list: C00–D49 (Neoplasms).

C78Not billable, use a more specific code below

Secondary malignant neoplasm of respiratory and digestive organs

In Malignant neoplasms of ill-defined, other secondary and unspecified sites (C76-C80), chapter 2: Neoplasms

15 billable codes under C78: all are a CC; 13 map to HCC 17 (Cancer Metastatic to Lung, Liver, Brain, and Other Organs; Acute Myeloid Leukemia Except Promyelocytic).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

Excludes1: not coded here, use a different code

secondary carcinoid tumors of liver (C7B.02)
secondary carcinoid tumors of peritoneum (C7B.04)

Excludes2: not included here, code separately if applicable

lymph node metastases (C77.0)

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 C78

C78 can't be used on a claim. Pick a billable code below; grey headings group them.

C78 MS-DRGs

As the principal diagnosis, the billable codes under C78 group to these 9 MS-DRGs (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.

DRG 180 Respiratory Neoplasms with MCC (9 of 15 codes)
DRG 181 Respiratory Neoplasms with CC (9 of 15 codes)
DRG 182 Respiratory Neoplasms without CC/MCC (9 of 15 codes)
DRG 374 Digestive Malignancy with MCC (5 of 15 codes)
DRG 375 Digestive Malignancy with CC (5 of 15 codes)
DRG 376 Digestive Malignancy without CC/MCC (5 of 15 codes)
DRG 435 Malignancy of Hepatobiliary System or Pancreas with MCC (1 of 15 codes)
DRG 436 Malignancy of Hepatobiliary System or Pancreas with CC (1 of 15 codes)
DRG 437 Malignancy of Hepatobiliary System or Pancreas without CC/MCC (1 of 15 codes)

About the condition

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

Cancer

Cancer is not just one disease but many diseases. Cancer begins in your cells, which are the building blocks of your body. Usually, your body forms new cells as needed, replacing old cells that die. Sometimes this process goes wrong. New cells grow even when you don't need them, and old cells don't die when they should. These extra cells can form a mass called a tumor.

Code history

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