ICD-10 · PDGM grouping
C69 Malignant neoplasm of eye and adnexa
All 27 codes in the C69 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
27
Can lead a claim
18
Cannot lead a claim
9
What CMS assigns to C69
18 of the 27 codes group to MMTA - Infectious Disease, Neoplasms, and Blood-Forming Diseases; 9 are assigned no clinical group. None of the 27 is assigned a comorbidity subgroup. 18 of the 27 can lead a claim.
Every code in C69
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 |
|---|---|---|---|---|
| C69.0 Malignant neoplasm of conjunctiva | ||||
| C69.00 | Malignant neoplasm of unspecified conjunctiva | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| C69.01 | Malignant neoplasm of right conjunctiva | Can lead a claim | K | None |
| C69.02 | Malignant neoplasm of left conjunctiva | Can lead a claim | K | None |
| C69.1 Malignant neoplasm of cornea | ||||
| C69.10 | Malignant neoplasm of unspecified cornea | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| C69.11 | Malignant neoplasm of right cornea | Can lead a claim | K | None |
| C69.12 | Malignant neoplasm of left cornea | Can lead a claim | K | None |
| C69.2 Malignant neoplasm of retina | ||||
| C69.20 | Malignant neoplasm of unspecified retina | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| C69.21 | Malignant neoplasm of right retina | Can lead a claim | K | None |
| C69.22 | Malignant neoplasm of left retina | Can lead a claim | K | None |
| C69.3 Malignant neoplasm of choroid | ||||
| C69.30 | Malignant neoplasm of unspecified choroid | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| C69.31 | Malignant neoplasm of right choroid | Can lead a claim | K | None |
| C69.32 | Malignant neoplasm of left choroid | Can lead a claim | K | None |
| C69.4 Malignant neoplasm of ciliary body | ||||
| C69.40 | Malignant neoplasm of unspecified ciliary body | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| C69.41 | Malignant neoplasm of right ciliary body | Can lead a claim | K | None |
| C69.42 | Malignant neoplasm of left ciliary body | Can lead a claim | K | None |
| C69.5 Malignant neoplasm of lacrimal gland and duct | ||||
| C69.50 | Malignant neoplasm of unspecified lacrimal gland and duct | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| C69.51 | Malignant neoplasm of right lacrimal gland and duct | Can lead a claim | K | None |
| C69.52 | Malignant neoplasm of left lacrimal gland and duct | Can lead a claim | K | None |
| C69.6 Malignant neoplasm of orbit | ||||
| C69.60 | Malignant neoplasm of unspecified orbit | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| C69.61 | Malignant neoplasm of right orbit | Can lead a claim | K | None |
| C69.62 | Malignant neoplasm of left orbit | Can lead a claim | K | None |
| C69.8 Malignant neoplasm of overlapping sites of eye and adnexa | ||||
| C69.80 | Malignant neoplasm of overlapping sites of unspecified eye and adnexaCMS: Malignant neoplasm of ovrlp sites of unsp eye and adnexa | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| C69.81 | Malignant neoplasm of overlapping sites of right eye and adnexaCMS: Malignant neoplasm of ovrlp sites of right eye and adnexa | Can lead a claim | K | None |
| C69.82 | Malignant neoplasm of overlapping sites of left eye and adnexaCMS: Malignant neoplasm of ovrlp sites of left eye and adnexa | Can lead a claim | K | None |
| C69.9 Malignant neoplasm of unspecified site of eye | ||||
| C69.90 | Malignant neoplasm of unspecified site of unspecified eye | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| C69.91 | Malignant neoplasm of unspecified site of right eye | Can lead a claim | K | None |
| C69.92 | Malignant neoplasm of unspecified site of left eye | Can lead a claim | K | 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.
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