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C25 ICD-10-CM Code: Malignant neoplasm of pancreas

Compare with another code for C25Check this code on a claim

Billing Status: NO. This is a non-billable ICD-10-CM code: report a more specific billable code beneath it.

Coding at a Glance

Tabular directives
1 Excludes1 · 1 Excludes2 · 2 use-additional instructions · 1 code-also instruction

Category · FY2027A non-billable heading in the tabular list: report a more specific code beneath it.

What you need to know

Source: CMS/NCHS Official ICD-10-CM tabular notes, quoted. From the CMS/NCHS tabular list for the release in force. A note the category or block publishes applies to this code too, and is marked with where it comes from.

Use additional codeReport with this code when documented
  • Use additional code to identify:
  • alcohol abuse and dependence (F10.-)
Excludes1from C15-C26Not reported with this code unless documented as unrelated
  • Kaposi's sarcoma of gastrointestinal sites (C46.4)
Code alsoMay be needed with this code
  • if applicable exocrine pancreatic insufficiency (K86.81)
Excludes2from C15-C26Not included here; may be reported together
  • gastrointestinal stromal tumors (C49.A-)

Where it sits Source: CMS/NCHS

Under:Chapter 2: NeoplasmsC00-C96 Malignant neoplasmsC00-C75 Malignant neoplasms, stated or presumed to be primary (of specified sites), and certain specified histologies, except neuroendocrine, and of lymphoid, hematopoietic and related tissueC15-C26 Malignant neoplasms of digestive organs

Codes under C25 (8)

  • C25.0Malignant neoplasm of head of pancreasBillable
  • C25.1Malignant neoplasm of body of pancreasBillable
  • C25.2Malignant neoplasm of tail of pancreasBillable
  • C25.3Malignant neoplasm of pancreatic ductBillable
  • C25.4Malignant neoplasm of endocrine pancreasBillable
  • C25.7Malignant neoplasm of other parts of pancreasBillable
  • C25.8Malignant neoplasm of overlapping sites of pancreasBillable
  • C25.9Malignant neoplasm of pancreas, unspecifiedBillable

Most relevant related codes MedCoder-derived

Read off the official notes above and this code’s own position in the tabular list. Which to report is a documentation question; Compare shows the two side by side.

CompareCheck ClaimView Related Codes

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for C25 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2027Effective: October 1, 2026

Trace:FY2027 changesChange historyRelease, file and checksum

Notes without a marker are published on C25 itself; “inherited from” names the category or block whose note applies here.

Excludes1 — Not Coded Here

Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Source: inherited from C15-C26

Excludes2 — Not Included Here

Conditions not covered by this code, but which may be reported alongside it when both are present.

Source: inherited from C15-C26

Code Also

Additional codes that may be required to fully describe the encounter.

  • if applicable exocrine pancreatic insufficiency (K86.81)

Use Additional Code

Supplementary codes the tabular list directs you to add.

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

Coder workflow for C25

MedCoder structured workflow — derived from this code’s own official record

Before you code C25

  1. C25 is not reportable as written. Select the more specific code beneath it that the documentation supports. Codes are reported to the highest level of specificity the classification provides (Guidelines I.B.2).

    ReviewC25.0, C25.1, C25.2, C25.3, C25.4, C25.7, C25.8, C25.9

    See the relationships section · Guide: How to choose an ICD-10-CM code →

  2. Confirm the documented site and behavior (this code’s block classifies malignant neoplasms), whether the site is primary or secondary, and whether the malignancy is current or a personal history: a previously excised malignancy with no further treatment and no evidence of disease is history, not current disease. Verify the site against the Table of Neoplasms. Neoplasm chapter guidelines (Guidelines I.C.2.a, I.C.2.d, I.C.2.m).

    See the Table of Neoplasms entries · Guide: Active cancer vs history of cancer →

  3. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with the code beneath C25. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).

    See the official tabular notes

Choose the right path

  1. Does the documentation support one of the more specific codes beneath C25?
    Yes → Select that code and continue the checks below on its own page.
    No → C25 cannot be reported as written. Where the codes beneath it include an unspecified code, that code applies when the record goes no further; otherwise query for the missing detail.

    ReviewC25.0, C25.1, C25.2, C25.3, C25.4, C25.7, C25.8, C25.9

  2. Does the documentation support a condition named in C25’s Excludes1 note?
    Yes → Do not simply proceed: review the excluded code. Both are reported only when the record shows the two conditions are unrelated.
    No → Continue.

    ReviewC46.4

Report the code beneath C25 that the documentation supports, not C25 itself. Then work the Use Additional Code note and review the Code Also note, and confirm that code is valid for the date of service on its own page.

Documentation check

The provider’s diagnostic statement
Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
Anatomical site
At the most specific level the record states; a site the classification separates cannot be assumed from a procedure or a measurement.
The conditions the Use Additional Code note names
Reported with this code when documented; a conditional instruction (“if applicable”, “if known”) applies only when the record supports it.
Behavior and current-versus-history status
Malignant, in situ, benign or uncertain; primary or secondary; current disease or personal history (Guidelines I.C.2.m).

Official instructions as workflow

  • Excludes1 — check before selecting C25(1 note)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with C25: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    CompareC46.4

    See the official tabular notes · Guidelines I.A.12.a

  • Excludes2 — not part of C25(1 note)

    Coding workflow: The conditions named in this note are not included in C25. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

    CompareC49.A

    See the official tabular notes · Guidelines I.A.12.b

  • Use Additional Code — after identifying C25(2 notes)

    Coding workflow: Check whether the documentation supports the additional code(s) the note names, and report them with C25 when it does. Where the instruction is conditional (“if applicable”, “if known”), it applies only when the record documents the condition.

    ReviewF10

    See the official tabular notes · Guidelines I.A.13

  • Code Also — related condition(1 note)

    Coding workflow: Review the related condition when both are documented and the instruction applies. A Code Also note does not fix sequencing; the order follows the circumstances of the encounter.

    ReviewK86.81

    See the official tabular notes · Guidelines I.A.17

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Documentation: Both the condition C25 describes and a condition named in its Excludes1 note are documented for the same encounter.

Coding question: Can both codes be reported?

Path: Review the Excludes1 note and the excluded code, and look for a provider statement on whether the two conditions are related.

Reason: Excludes1 means the two are not coded together; the exception is when the record shows the conditions are unrelated to each other (Guidelines I.A.12.a).

ReviewC46.4

Documentation: A condition the Use Additional Code note names is documented.

Coding question: Is a second code reported with the code beneath C25?

Path: Review the Use Additional Code note and the code it names.

Reason: The additional code is reported when the record documents the condition; a conditional instruction applies only when its condition is met (Guidelines I.A.13).

ReviewF10

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Don’t confuse C25 with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of C25 — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

  • C46.4— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of Kaposi's sarcoma of gastrointestinal sites moves the case to C46.4; the two are not reported together unless documented as unrelated.

    Full comparison: C25 vs C46.4 →

  • C49.A— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of gastrointestinal stromal tumors adds C49.A; it is not part of this code and both may be reported when both are documented.

    Full comparison: C25 vs C49.A →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

Coding context

Guidelines, coding notes, decision aids, relationships (with MS-DRG and CCSR classification), hierarchy, HCC, coverage and the context map: what a coder reaches for after the core. Each section names whether it is official source data, a MedCoder-derived relationship or MedCoder editorial.

Code Overview

Malignant neoplasm of pancreas is a non-billable ICD-10-CM category code (C25). A more specific billable subcode must be selected for claims submission.

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Decision Points

The directives on this code's own record, as a pre-claim checklist.

  1. 2 Use Additional Code instructions — report the named additional code(s) when the documentation supports them. See the Use Additional Code notes
  2. 1 Code Also note — a second code may apply; the guidelines leave its sequencing to the circumstances of the encounter. See the Code Also notes
  3. 1 Excludes1 entry — codes named there are generally not reported together with this code (Guidelines I.A.12.a). See the Excludes1 notes
  4. 1 Excludes2 entry — those conditions are not part of this code and may be reported additionally when documented. See the Excludes2 notes

Checklist rows are derived from this code's own official directives; the wording of each check is MedCoder editorial. The official notes themselves are in the sections each row links to.

Verify Before Coding

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Contextual Map

Every relationship of C25 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run C25 with these 4 related codes in Claim Check

Hierarchy

Excludes1

Excludes2

Use Additional Code

Code Also

Nearest codes

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Reference

Index terms and tables, published questions and FAQ, every source behind this page with its release and checksum, the date-of-service check and the complete change history.

Common coding questions

MedCoder editorial

Can C25 be billed directly?

No. C25 (Malignant neoplasm of pancreas) is a non-billable ICD-10-CM category code. A more specific billable subcode must be selected based on clinical documentation.

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data
CMS/CDC ICD-10-CM FY2027 tabular list, index and tables, effective October 1, 2026 Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v44.0 (October 2026) Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data
CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder-derived relationship
Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder editorial explanation
Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCCI PTP Q4 2026 · MUE Q4 2026 · NCD code lists 2026-01 · LCD export September 28, 2026 · All releases and sources

Labels on this page: Official source data · MedCoder-derived relationship · MedCoder editorial explanation. How to read the labels · All data sources and release dates · CMS coding rules

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "C25 — Malignant neoplasm of pancreas." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/c25-malignant-neoplasm-of-pancreas

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Malignant neoplasm of pancreas

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027, and none are recorded for this code. Note changes are tracked from FY2027 only.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to C25 in its code family, with their registry titles.