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C69.62 ICD-10-CM Code: Malignant neoplasm of left orbit

Compare with another codeCheck this code on a claim

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Coding at a Glance

Tabular directives
4 Excludes1
Risk adjustment
CMS-HCC V28: 1 category · CMS-HCC V22 category 12 · RxHCC V08 category 22

Billable · FY2027A valid, specific ICD-10-CM code, reportable for dates of service in FY2027.

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; the Instructions section marks which is which.

Excludes1Never report with this code
  • malignant neoplasm of orbital bone (C41.0)
  • malignant neoplasm of connective tissue of eyelid (C49.0)
  • malignant neoplasm of eyelid (skin) (C43.1-, C44.1-)
  • malignant neoplasm of optic nerve (C72.3-)

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

Inpatient Payment Groups (MS-DRG)

Potential MS-DRG participation — not a DRG assignment.

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v44, Appendix B.

  • MS-DRG 124 — OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT (MDC 02)
  • MS-DRG 125 — OTHER DISORDERS OF THE EYE WITHOUT MCC (MDC 02)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Risk Adjustment (CMS-HCC)

Payment categories this diagnosis maps to under CMS-HCC V28, payment year 2026.

  • HCC 23 — Prostate, Breast, and Other Cancers and Tumors

Other models: CMS-HCC V22 HCC 12 · RxHCC V08 HCC 22

Risk scores depend on the enrollee's full accepted diagnosis set and segment; a category mapping alone does not determine payment.

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for C69.62 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 C69.62 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).

Coder workflow for C69.62

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

Before you code C69.62

  1. Laterality is coded in this family. Confirm the side documented — right, left, or bilateral — and select the matching code (this page’s code: left). The unspecified-side code applies only when the record states no side. Laterality is assigned from the documented side; where a bilateral code exists and both sides are documented, it is used instead of two unilateral codes (Guidelines I.B.13).

    ReviewC69.61 · right, C69.60 · unspecified

    Guide: Laterality coding →

  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 C69.62. 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 a condition named in C69.62’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.

    ReviewC41.0, C49.0, C43.1, C44.1, C72.3

  2. Is the side documented?
    Yes → Select the code for the documented side (or the bilateral code when both sides are documented and one exists).
    No → Use the unspecified-side code only when the record states no side; a query is the alternative.

    ReviewC69.61 · right, C69.60 · unspecified

Consider C69.62. Then confirm the code is valid for the date of service in the Verify section.

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.
Laterality
Right, left or bilateral as documented; unspecified only when the record states no side (Guidelines I.B.13).
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 C69.62(4 notes)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with C69.62: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    CompareC41.0, C49.0, C43.1, C44.1, C72.3

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

Coding decision scenarios

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

Documentation: Both the condition C69.62 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).

ReviewC41.0, C49.0, C43.1, C44.1, C72.3

Documentation: The record documents the condition on one side only.

Coding question: Which code in this family applies?

Path: Select the sibling code for the documented side.

Reason: Laterality is assigned from the documented side; the unspecified-side code is for records that state no side (Guidelines I.B.13).

ReviewC69.61 · right, C69.60 · unspecified

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 C69.62 with…

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

The codes most likely to be picked instead of C69.62 — 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.

  • C41.0— 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 malignant neoplasm of orbital bone moves the case to C41.0; the two are not reported together unless documented as unrelated.

    Full comparison: C69.62 vs C41.0 →

  • C49.0— 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 malignant neoplasm of connective tissue of eyelid moves the case to C49.0; the two are not reported together unless documented as unrelated.

    Full comparison: C69.62 vs C49.0 →

  • C43.1— 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 malignant neoplasm of eyelid (skin) moves the case to C43.1; the two are not reported together unless documented as unrelated.

    Full comparison: C69.62 vs C43.1 →

  • C44.1— 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 malignant neoplasm of eyelid (skin) moves the case to C44.1; the two are not reported together unless documented as unrelated.

    Full comparison: C69.62 vs C44.1 →

  • C72.3— 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 malignant neoplasm of optic nerve moves the case to C72.3; the two are not reported together unless documented as unrelated.

    Full comparison: C69.62 vs C72.3 →

  • C69.60— Specificity relationship (Review)

    Overlapping diagnoses in the same category.

    Overlapping codes in the same category — the documentation decides which is the more specific fit.

    What moves you there: A record that documents no more than “Malignant neoplasm of unspecified orbit” takes C69.60; specificity in the record moves it back here.

    Full comparison: C69.62 vs C69.60 →

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 left orbit is a billable ICD-10-CM diagnosis code (C69.62).

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

Verify Before Coding

  • No Medicare Code Editor or MS-DRG Definitions Manual restrictions apply to this code.

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

Relationships & Classification

MedCoder-derived relationships — computed from published CMS and AHRQ datasets

Other codes that name C69.62 or its code family, from the CMS ICD-10-CM tabular instructional notes and the CMS Table of Neoplasms. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 3 Excludes1 notes: C47.0 — Malignant neoplasm of peripheral nerves of head, face and neck (via C69.6.-), C49.0 — Malignant neoplasm of connective and soft tissue of head, face and neck (via C69.6.-), C71 — Malignant neoplasm of brain (via C69.6.-).

These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.

Referenced by 7 Same-site neoplasm codes: C79.49 — Secondary malignant neoplasm of other parts of nervous system (via C69.6.-)Compare C69.62 vs C79.49 →, D09.2 — Carcinoma in situ of eye (via C69.6.-)Compare C69.62 vs D09.2 →, D31.6 — Benign neoplasm of unspecified site of orbit (via C69.6.-)Compare C69.62 vs D31.6 →, D48.1 — Neoplasm of uncertain behavior of connective and other soft tissue (via C69.6.-)Compare C69.62 vs D48.1 →, D48.7 — Neoplasm of uncertain behavior of other specified sites (via C69.6.-)Compare C69.62 vs D48.7 →, D49.2 — Neoplasm of unspecified behavior of bone, soft tissue, and skin (via C69.6.-)Compare C69.62 vs D49.2 →, D49.89 — Neoplasm of unspecified behavior of other specified sites (via C69.6.-)Compare C69.62 vs D49.89 →.

These codes represent related neoplasm behaviors affecting the same anatomic site.

MS-DRG Grouper Relationships (FY2027)

Potential MS-DRG participation — not a DRG assignment.

FY2027 MS-DRG: not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity for that release.

Named in the grouper logic of 2 MS-DRGs: DRG 124 (MDC 02), DRG 125 (MDC 02).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):NEO001 — Head and neck cancers - eye (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same condition, opposite side

Same category and title, differing only in which side of the body is affected.

C69.60 — Malignant neoplasm of unspecified orbit (unspecified)Compare C69.62 vs C69.60 →, C69.61 — Malignant neoplasm of right orbit (right)Compare C69.62 vs C69.61 →

Same CMS-HCC risk category (V28)

CMS maps these diagnoses to the same Hierarchical Condition Category (Prostate, Breast, and Other Cancers and Tumors) for risk-adjusted payment.

C69.31 — Malignant neoplasm of right choroid, C69.32 — Malignant neoplasm of left choroid, C69.40 — Malignant neoplasm of unspecified ciliary body, C69.41 — Malignant neoplasm of right ciliary body, C69.42 — Malignant neoplasm of left ciliary body, C69.50 — Malignant neoplasm of unspecified lacrimal gland and duct, C69.51 — Malignant neoplasm of right lacrimal gland and duct, C69.52 — Malignant neoplasm of left lacrimal gland and duct, C69.60 — Malignant neoplasm of unspecified orbit, C69.61 — Malignant neoplasm of right orbit, C69.80 — Malignant neoplasm of overlapping sites of unspecified eye and adnexa, C69.81 — Malignant neoplasm of overlapping sites of right eye and adnexa, C69.82 — Malignant neoplasm of overlapping sites of left eye and adnexa, C69.90 — Malignant neoplasm of unspecified site of unspecified eye, C69.91 — Malignant neoplasm of unspecified site of right eye, C69.92 — Malignant neoplasm of unspecified site of left eye, C73 — Malignant neoplasm of thyroid gland, C75.0 — Malignant neoplasm of parathyroid gland, C75.4 — Malignant neoplasm of carotid body, C75.5 — Malignant neoplasm of aortic body and other paraganglia, +213 more

Related risk categories

These categories interact through CMS's HCC hierarchy — one can suppress the other's risk-adjustment weight when both are present on a claim.

Cancer Metastatic to Lung, Liver, Brain, and Other Organs; Acute Myeloid Leukemia Except Promyelocytic, Cancer Metastatic to Bone, Other and Unspecified Metastatic Cancer; Acute Leukemia Except Myeloid, Myelodysplastic Syndromes, Multiple Myeloma, and Other Cancers, Lung and Other Severe Cancers, Lymphoma and Other Cancers, Bladder, Colorectal, and Other Cancers

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Head and neck cancers - eye).

C69.30 — Malignant neoplasm of unspecified choroid, C69.31 — Malignant neoplasm of right choroid, C69.32 — Malignant neoplasm of left choroid, C69.40 — Malignant neoplasm of unspecified ciliary body, C69.41 — Malignant neoplasm of right ciliary body, C69.42 — Malignant neoplasm of left ciliary body, C69.50 — Malignant neoplasm of unspecified lacrimal gland and duct, C69.51 — Malignant neoplasm of right lacrimal gland and duct, C69.52 — Malignant neoplasm of left lacrimal gland and duct, C69.60 — Malignant neoplasm of unspecified orbit, C69.61 — Malignant neoplasm of right orbit, C69.80 — Malignant neoplasm of overlapping sites of unspecified eye and adnexa, C69.81 — Malignant neoplasm of overlapping sites of right eye and adnexa, C69.82 — Malignant neoplasm of overlapping sites of left eye and adnexa, C69.90 — Malignant neoplasm of unspecified site of unspecified eye, C69.91 — Malignant neoplasm of unspecified site of right eye, C69.92 — Malignant neoplasm of unspecified site of left eye, D09.20 — Carcinoma in situ of unspecified eye, D09.21 — Carcinoma in situ of right eye, D09.22 — Carcinoma in situ of left eye, +9 more

Lab tests where this diagnosis supports Medicare coverage (NCD)

Medicare's National Coverage Determination (NCD) program lists this diagnosis as medical justification for these lab tests.

Iron Panel

Contextual Map

Every relationship of C69.62 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 C69.62 with these 3 related codes in Claim Check

Hierarchy

Referenced by Excludes1 notes

Referenced by Same-site neoplasm codes

Clinical classification (CCSR)

Risk adjustment (CMS-HCC)

  • HCC 23 — Prostate, Breast, and Other Cancers and Tumors [CMS-HCC]— CMS-HCC V28 · 2026

MS-DRG Grouper

MDC crossing

  • MDC 02 — Diseases and Disorders of the Eye[MDC crossing]: “Diseases and Disorders of the Eye — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 1,200 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2027

Neoplasm sites (11)

  • Neoplasm, neoplastic, connective tissue NEC, orbit — Neoplasm, neoplastic, connective tissue NEC, orbit — Malignant, Primary [Neoplasm table]: “Neoplasm, neoplastic, connective tissue NEC, orbit (Malignant, Primary)”— CMS Table of Neoplasms · icd10cm-fy2027
  • Neoplasm, neoplastic, extraocular muscle — Neoplasm, neoplastic, extraocular muscle — Malignant, Primary [Neoplasm table]: “Neoplasm, neoplastic, extraocular muscle (Malignant, Primary)”— CMS Table of Neoplasms · icd10cm-fy2027
  • Neoplasm, neoplastic, intraorbital — Neoplasm, neoplastic, intraorbital — Malignant, Primary [Neoplasm table]: “Neoplasm, neoplastic, intraorbital (Malignant, Primary)”— CMS Table of Neoplasms · icd10cm-fy2027
  • Neoplasm, neoplastic, muscle, extraocular — Neoplasm, neoplastic, muscle, extraocular — Malignant, Primary [Neoplasm table]: “Neoplasm, neoplastic, muscle, extraocular (Malignant, Primary)”— CMS Table of Neoplasms · icd10cm-fy2027
  • Neoplasm, neoplastic, nerve (ganglion), peripheral NEC, orbit — Neoplasm, neoplastic, nerve (ganglion), peripheral NEC, orbit — Malignant, Primary [Neoplasm table]: “Neoplasm, neoplastic, nerve (ganglion), peripheral NEC, orbit (Malignant, Primary)”— CMS Table of Neoplasms · icd10cm-fy2027
  • Neoplasm, neoplastic, orbit — Neoplasm, neoplastic, orbit — Malignant, Primary [Neoplasm table]: “Neoplasm, neoplastic, orbit (Malignant, Primary)”— CMS Table of Neoplasms · icd10cm-fy2027
  • Neoplasm, neoplastic, orbit, autonomic nerve — Neoplasm, neoplastic, orbit, autonomic nerve — Malignant, Primary [Neoplasm table]: “Neoplasm, neoplastic, orbit, autonomic nerve (Malignant, Primary)”— CMS Table of Neoplasms · icd10cm-fy2027
  • Neoplasm, neoplastic, orbit, eye — Neoplasm, neoplastic, orbit, eye — Malignant, Primary [Neoplasm table]: “Neoplasm, neoplastic, orbit, eye (Malignant, Primary)”— CMS Table of Neoplasms · icd10cm-fy2027
  • and 3 more

Nearest codes (36)

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.

Neoplasm Table Sites (11)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Anatomical sites from the official ICD-10-CM Table of Neoplasms that map to this code, with the matching behavior column.

  • Neoplasm, neoplastic, connective tissue NEC, orbit — Malignant, Primary
  • Neoplasm, neoplastic, extraocular muscle — Malignant, Primary
  • Neoplasm, neoplastic, intraorbital — Malignant, Primary
  • Neoplasm, neoplastic, muscle, extraocular — Malignant, Primary
  • Neoplasm, neoplastic, nerve (ganglion), peripheral NEC, orbit — Malignant, Primary
  • Neoplasm, neoplastic, orbit — Malignant, Primary
  • Neoplasm, neoplastic, orbit, autonomic nerve — Malignant, Primary
  • Neoplasm, neoplastic, orbit, eye — Malignant, Primary
  • Neoplasm, neoplastic, orbit, peripheral nerves — Malignant, Primary
  • Neoplasm, neoplastic, orbit, soft parts — Malignant, Primary
  • Neoplasm, neoplastic, retrobulbar — Malignant, Primary

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
Inpatient payment groups Official source data
CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v44 Release, file and checksum · Publisher’s page
Risk adjustment Official source data
2026 Mid-Year Final ICD-10 Mappings + Model Software (cms.gov/files/zip/2026-midyear-final-icd-10-mappings.zip, 2026-midyear-final-model-software.zip) — CMS-HCC V28, PY2026 mid-year final release 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 20, 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. "C69.62 — Malignant neoplasm of left orbit." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/c69.62-malignant-neoplasm-of-left-orbit

Change history

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

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 C69.62 in its code family, with their registry titles.

View all codes in the C69 family