Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • NPI Medicare & Medicaid
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.28
    OpenPayerBilling CodesMalignant neoplasms of digestive organsICD-10-CM c20-malignant-neoplasm-of-rectum
    Ask Trek AI about this page

    ICD-10-CM Code For Malignant Neoplasm Of Rectum: Group Overview

    The International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) code group C20 includes malignant neoplasms originating in the rectum, covering primary rectal adenocarcinomas and other malignant tumors of rectal tissue. These ICD-10-CM diagnosis codes are used to document clinical scenarios such as tumor location, local extension, and metastatic involvement relevant to rectal cancer management. Accurate coding within the ICD-10-CM C20 group supports proper claim adjudication, complete clinical documentation, and appropriate reimbursement.

    Customize your policy alerts

    Sign up for ICD-10-CM Code For Malignant Neoplasm Of Rectum: Group Overview policy alerts

    Get alerted when relevant policies change without checking for updates manually.

    Monitor payer policy activity

    Receive email alerts as soon as relevant payer policies are published or updated.

    ICD-10-CM C20: Malignant Neoplasm Of Rectum Overview

    The malignant neoplasm of rectum group represents primary cancers originating in the rectal tissue of the lower gastrointestinal tract. These diagnoses target colorectal oncology and related local invasion or metastasis. Accurate coding is important for reflecting disease site and extent, which affects clinical documentation and reimbursement processing.

    Table of contents

    Progress1 / 6

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools

    When to Use

    Use a code from this group when a patient has a confirmed malignant neoplasm of the rectum documented by clinical, imaging, or pathological findings. Codes from this group are applied to reflect the site-specific diagnosis for treatment planning, reporting, and billing purposes.

    ICD-10-CM Codes

    1 rows

    ICD-10-CM CodeDescription
    C20Malignant neoplasm of rectum

    DRG Codes

    3 rows

    DRG CodeDescription
    374Digestive Malignancy with MCC
    375Digestive Malignancy with CC
    376Digestive Malignancy without CC/MCC

    Typical Clinical Scenarios

    • An older adult with new onset rectal bleeding, change in bowel habits, and unintentional weight loss presents to gastroenterology for colonoscopy; biopsy of an exophytic rectal mass confirms invasive adenocarcinoma of the rectum, and the patient is staged and referred for oncologic management. Typical codes: C20.
    • A middle-aged patient with a history of treated rectal cancer who develops progressive pelvic pain and a palpable rectal mass on follow-up imaging returns for evaluation and restaging; persistent or recurrent primary tumor in the rectum is documented by biopsy and imaging, prompting assignment of the rectal malignancy code for current treatment planning. Typical codes: C20.
    • An emergency department presentation of an elderly patient with acute bowel obstruction symptoms (severe abdominal pain, vomiting, absence of flatus) found on imaging to have an obstructing rectal tumor requiring urgent decompression or surgery; the rectal malignancy is recorded as the underlying cause of the acute complication. Typical codes: C20.

    Related Codes

    C15-MALIGNANT-NEOPLASM-OF-ESOPHAGUS

    ICD-10-CM Code For Malignant Neoplasm Of Esophagus: Group Overview

    C16-MALIGNANT-NEOPLASM-OF-STOMACH

    ICD-10-CM Code For Malignant Neoplasm Of Stomach: Group Overview

    C17-MALIGNANT-NEOPLASM-OF-SMALL-INTESTINE

    ICD-10-CM Code For Malignant Neoplasm Of Small Intestine: Group Overview

    C18-MALIGNANT-NEOPLASM-OF-COLON

    ICD-10-CM Code For Malignant Neoplasm Of Colon: Group Overview

    C19-MALIGNANT-NEOPLASM-OF-RECTOSIGMOID-JUNCTION

    ICD-10-CM Code For Malignant Neoplasm Of Rectosigmoid Junction: Group Overview

    C21-MALIGNANT-NEOPLASM-OF-ANUS-AND-ANAL-CANAL

    ICD-10-CM Code For Malignant Neoplasm Of Anus And Anal Canal: Group Overview

    C22-MALIGNANT-NEOPLASM-OF-LIVER

    ICD-10-CM Code For Malignant Neoplasm Of Liver And Intrahepatic Bile Ducts: Group Overview

    C23-MALIGNANT-NEOPLASM-OF-GALLBLADDER

    ICD-10-CM Code For Malignant Neoplasm Of Gallbladder: Group Overview

    C24-MALIGNANT-NEOPLASM-BILIARY-TRACT

    ICD-10-CM Code For Malignant Neoplasm Of Other And Unspecified Parts Of Biliary Tract: Group Overview

    C26-MALIGNANT-NEOPLASM-OTHER-ILL-DEFINED-DIGESTIVE-ORGANS

    ICD-10-CM Code For Malignant Neoplasm Of Other And Ill-Defined Digestive Organs: Group Overview

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
    Published by

    Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.