C09.8

Malignant neoplasm of overlapping sites of tonsil

FY2027Chapter 2: Neoplasms/C00–C14 Malignant neoplasms of lip, oral cavity and pharynx

BillableComplete code, valid to report

C09.8 (also written C098) is a billable ICD-10-CM diagnosis code for malignant neoplasm of overlapping sites of tonsil. It is part of the FY2027 code set, effective October 1, 2026. It is one of the 4 codes in category C09 (Malignant neoplasm of tonsil). Its coding notes include a Use additional code instruction and 2 Excludes2 entries.

Guidelines tip

From the FY2027 Official Guidelines. ICD10Ref adds no rules of its own.

A primary malignancy code stays in use until treatment directed at that site is completed. After that, with no evidence of disease at the site, Z85 gives the former site.

Guidelines I.C.2.mCurrent malignancy versus personal history of malignancyRead the official text

Use additional code

Add the listed code as a secondary code, if known.

Inherited from C09 Malignant neoplasm of tonsil
  • code to identify:
    • alcohol abuse and dependence (F10.-)
    • exposure to environmental tobacco smoke (Z77.22)
    • exposure to tobacco smoke in the perinatal period (P96.81)
    • history of tobacco dependence (Z87.891)
    • occupational exposure to environmental tobacco smoke (Z57.31)
    • tobacco dependence (F17.-)
    • tobacco use (Z72.0)

Excludes2

Not included here. Both codes may be reported if the patient has both conditions.

Inherited from C09 Malignant neoplasm of tonsil
  • malignant neoplasm of lingual tonsil (C02.4)
  • malignant neoplasm of pharyngeal tonsil (C11.1)

Care settings

How CMS programs treat this code. These are CMS claim edits and list entries, not coverage or eligibility rules.

Home Health Primary

Accepted as the primary (principal) diagnosis on a home health claim. The Home Health Grouper assigns it to the MMTA - Infectious Disease, Neoplasms, and Blood-Forming Diseases clinical group.

Source: CMS Home Health Grouper Software v07.2.26, effective October 1, 2026

IPF Comorbidity

On the CMS IPF comorbidity list.

Comorbidity categoryFactor
Oncology Treatment1.44
It counts as a comorbidity when reported as a secondary diagnosis and actively treated during the stay. An IPF receives only one adjustment within a category and can receive adjustments in more than one category.

Source: CMS IPF PPS FY 2027 final rule (CMS-1847-F), Addendum B-3 (comorbidity codes with adjustment factor); effective for discharges on or after October 1, 2026

Notes

Also from chapter/block level (8 notes)
Inherited from Chapter 2 Neoplasms
  • Functional activity
  • All neoplasms are classified in this chapter, whether they are functionally active or not. An additional code from Chapter 4 may be used, to identify functional activity associated with any neoplasm.
  • Morphology [Histology]
  • Chapter 2 classifies neoplasms primarily by site (topography), with broad groupings for behavior, malignant, in situ, benign, etc. The Table of Neoplasms should be used to identify the correct topography code. In a few cases, such as for malignant melanoma and certain neuroendocrine tumors, the morphology (histologic type) is included in the category and codes.
  • Primary malignant neoplasms overlapping site boundaries
  • A primary malignant neoplasm that overlaps two or more contiguous (next to each other) sites should be classified to the subcategory/code .8 ('overlapping lesion'), unless the combination is specifically indexed elsewhere. For multiple neoplasms of the same site that are not contiguous, such as tumors in different quadrants of the same breast, codes for each site should be assigned.
  • Malignant neoplasm of ectopic tissue
  • Malignant neoplasms of ectopic tissue are to be coded to the site mentioned, e.g., ectopic pancreatic malignant neoplasms are coded to pancreas, unspecified (C25.9).