ICD-10 · PDGM grouping
C00 Malignant neoplasm of lip
All 9 codes in the C00 family, with the PDGM clinical group, comorbidity subgroup and primary-position rule CMS assigns, read from the CMS grouper crosswalk v07.2.26 and the CDC FY2027 code file.
Codes in family
9
Can lead a claim
6
Cannot lead a claim
3
What CMS assigns to C00
6 of the 9 codes group to MMTA - Infectious Disease, Neoplasms, and Blood-Forming Diseases; 3 are assigned no clinical group. 5 of the 9 count toward the Malignant neoplasm of Lip, Oral cavity and Pharynx, includes Head and Neck Cancers comorbidity subgroup; 4 are assigned none. 6 of the 9 can lead a claim.
- Malignant neoplasm of Lip, Oral cavity and Pharynx, includes Head and Neck Cancers
Every code in C00
Descriptions are CDC’s FY2027 wording; where CMS’s grouper abbreviates one, its form is shown beneath.
| Code | Description | Primary position | Clinical group | Comorbidity subgroup |
|---|---|---|---|---|
| C00.0 | Malignant neoplasm of external upper lip | Can lead a claim | K | Malignant neoplasm of Lip, Oral cavity and Pharynx, includes Head and Neck Cancers |
| C00.1 | Malignant neoplasm of external lower lip | Can lead a claim | K | Malignant neoplasm of Lip, Oral cavity and Pharynx, includes Head and Neck Cancers |
| C00.2 | Malignant neoplasm of external lip, unspecified | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| C00.3 | Malignant neoplasm of upper lip, inner aspect | Can lead a claim | K | Malignant neoplasm of Lip, Oral cavity and Pharynx, includes Head and Neck Cancers |
| C00.4 | Malignant neoplasm of lower lip, inner aspect | Can lead a claim | K | Malignant neoplasm of Lip, Oral cavity and Pharynx, includes Head and Neck Cancers |
| C00.5 | Malignant neoplasm of lip, unspecified, inner aspect | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| C00.6 | Malignant neoplasm of commissure of lip, unspecified | Can lead a claim | K | None |
| C00.8 | Malignant neoplasm of overlapping sites of lip | Can lead a claim | K | Malignant neoplasm of Lip, Oral cavity and Pharynx, includes Head and Neck Cancers |
| C00.9 | Malignant neoplasm of lip, unspecified | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
Sources: CMS HH PPS Grouper Software v07.2.26, effective 2026-10-01, for the clinical group, comorbidity subgroup, code-first conventions and primary-position flags; CDC NCHS ICD-10-CM FY2027 code descriptions for the family title and code wording. This is the crosswalk Medicare runs a claim through. Grouping also depends on admission source, timing, the OASIS functional items and the rest of the diagnosis list.
The monthly home health regs digest
What CMS changed, what's due next, and what to do about it — one email a month, no fluff. Read the first issue