ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 C81.44

Billable / Specific HCC v28: 10 CC

Lymphocyte-rich Hodgkin lymphoma, lymph nodes of axilla and upper limb

C81
Block
0
Synonyms
694
LCDs
36
Payer Policies
13
Linked CPTs

About ICD-10-CM C81.44

ICD-10-CM code C81.44 represents Lymphocyte-rich Hodgkin lymphoma, lymph nodes of axilla and upper limb. This is a billable/specific code in the chapter (block C81). The 2026 edition of ICD-10-CM C81.44 became effective on October 1, 2025.

Coding Tips for C81.44

Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.

HCC capture: document with MEAT each year

C81.44 is a CMS-HCC v28 risk-adjustment code (category 10). To count for the patient Risk Adjustment Factor (RAF), document the diagnosis with MEAT language each calendar year: Monitored, Evaluated, Assessed, Treated. A diagnosis on the problem list alone does not satisfy CMS RADV audit standards. Include the diagnosis in the assessment with current status and current treatment plan.

Inpatient DRG impact: CC

C81.44 is designated CC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-CC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag CC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.

Medicare Advantage HCC Impact

CMS-HCC v28 (current)
Category 10
ESRD-HCC
Category 10
RxHCC (Part D)
Category 10

Capture this diagnosis annually for accurate risk adjustment. Missed HCC captures are the #1 revenue leak in Medicare Advantage risk programs.

Inpatient DRG Impact, CC

codes Lymphocyte-rich Hodgkin lymphoma, lymph nodes of axilla and upper limb. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.

Medicare LCD Coverage for C81.44

Local Coverage Determinations (LCDs) from CMS MACs that list C81.44 as a covered diagnosis.

694 LCDs

Showing top 10 of 694 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Radiation Therapies
Article ID: 59350, Effective: 2026-01-01 00:00:00, 757 covered, 0 non-covered
CPT 77402 →
CMS LCD: Billing and Coding: Radiation Therapies
Article ID: 59350, Effective: 2026-01-01 00:00:00, 757 covered, 0 non-covered
CPT 77371 →
CMS LCD: Billing and Coding: Radiation Therapies
Article ID: 59350, Effective: 2026-01-01 00:00:00, 757 covered, 0 non-covered
CPT 61797 →
CMS LCD: Billing and Coding: Radiation Therapies
Article ID: 59350, Effective: 2026-01-01 00:00:00, 757 covered, 0 non-covered
CPT G0339 →
CMS LCD: Billing and Coding: Radiation Therapies
Article ID: 59350, Effective: 2026-01-01 00:00:00, 757 covered, 0 non-covered
CPT 77338 →
CMS LCD: Billing and Coding: Radiation Therapies
Article ID: 59350, Effective: 2026-01-01 00:00:00, 757 covered, 0 non-covered
CPT 77432 →
CMS LCD: Billing and Coding: Radiation Therapies
Article ID: 59350, Effective: 2026-01-01 00:00:00, 757 covered, 0 non-covered
CPT 61800 →
CMS LCD: Billing and Coding: Radiation Therapies
Article ID: 59350, Effective: 2026-01-01 00:00:00, 757 covered, 0 non-covered
CPT 77372 →
CMS LCD: Billing and Coding: Radiation Therapies
Article ID: 59350, Effective: 2026-01-01 00:00:00, 757 covered, 0 non-covered
CPT 77435 →
CMS LCD: Billing and Coding: Radiation Therapies
Article ID: 59350, Effective: 2026-01-01 00:00:00, 757 covered, 0 non-covered
CPT 77407 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing C81.44.

36 policies

5 Medicare

Oral Anticancer Drugs - Policy Article
Policy ID: ART-52479
Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) - Policy Article
Policy ID: ART-52480
Billing and Coding: Cardiac Blood Pool Imaging (Multiple Gated Acquisition Scanning- MUGA, Ventriculography) When Performed in Conjunction with Cardiotoxic Chemotherapy
Policy ID: ART-54768
Billing and Coding: Lab: Flow Cytometry
Policy ID: ART-55717
Billing and Coding: Rituximab
Policy ID: ART-56380

CPT Codes Commonly Billed with C81.44

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

13 linkages
  • Q5123 CMS LCD: Billing and Coding: Off-label Use of Rituximab and Rituximab Biosimilars CMS LCD
  • J9312 CMS LCD: Billing and Coding: Off-label Use of Rituximab and Rituximab Biosimilars CMS LCD
  • Q5115 CMS LCD: Billing and Coding: Off-label Use of Rituximab and Rituximab Biosimilars CMS LCD
  • Q5119 CMS LCD: Billing and Coding: Off-label Use of Rituximab and Rituximab Biosimilars CMS LCD
  • 38240 CMS LCD: Billing and Coding: Allogeneic Hematopoietic Cell Transplantation for Primary Refractory or Relapsed Hodgkin's and Non-Hodgkin's Lymphoma with B-cell or T-cell Origin CMS LCD
  • J9311 CMS LCD: Billing and Coding: Rituximab CMS LCD
  • J3590 CMS LCD: Billing and Coding: Rituximab CMS LCD
  • 85651 CMS LCD: Billing and Coding: Sedimentation Rate, Erythrocyte CMS LCD
  • 85652 CMS LCD: Billing and Coding: Sedimentation Rate, Erythrocyte CMS LCD
  • A9611 CMS LCD: Billing and Coding: Cardiac Radionuclide Imaging CMS LCD

Convert C81.44 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
C81.44 20144 10000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

Codes Adjacent To C81.44

Other codes in section C81-C96 (Malignant neoplasms of lymphoid, hematopoietic and related tissue).

C81 Hodgkin lymphoma (non-billable) C81.0 Nodular lymphocyte predominant Hodgkin lymphoma (non-billable) C81.00 Nodular lymphocyte predominant Hodgkin lymphoma, unspecified site C81.01 Nodular lymphocyte predominant Hodgkin lymphoma, lymph nodes of head, face, and neck C81.02 Nodular lymphocyte predominant Hodgkin lymphoma, intrathoracic lymph nodes C81.03 Nodular lymphocyte predominant Hodgkin lymphoma, intra-abdominal lymph nodes C81.04 Nodular lymphocyte predominant Hodgkin lymphoma, lymph nodes of axilla and upper limb C81.05 Nodular lymphocyte predominant Hodgkin lymphoma, lymph nodes of inguinal region and lower limb C81.06 Nodular lymphocyte predominant Hodgkin lymphoma, intrapelvic lymph nodes C81.07 Nodular lymphocyte predominant Hodgkin lymphoma, spleen C81.08 Nodular lymphocyte predominant Hodgkin lymphoma, lymph nodes of multiple sites C81.09 Nodular lymphocyte predominant Hodgkin lymphoma, extranodal and solid organ sites C81.0A Nodular lymphocyte predominant Hodgkin lymphoma, in remission C81.1 Nodular sclerosis Hodgkin lymphoma (non-billable) C81.10 Nodular sclerosis Hodgkin lymphoma, unspecified site C81.11 Nodular sclerosis Hodgkin lymphoma, lymph nodes of head, face, and neck C81.12 Nodular sclerosis Hodgkin lymphoma, intrathoracic lymph nodes C81.13 Nodular sclerosis Hodgkin lymphoma, intra-abdominal lymph nodes C81.14 Nodular sclerosis Hodgkin lymphoma, lymph nodes of axilla and upper limb C81.15 Nodular sclerosis Hodgkin lymphoma, lymph nodes of inguinal region and lower limb

ICD-10 C81.44, Billing FAQ

Is ICD-10 code C81.44 billable? +

Yes, C81.44 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

Does C81.44 affect Medicare Advantage HCC risk adjustment? +

Yes. C81.44 maps to CMS-HCC v28 category 10. Capture this diagnosis annually for accurate Medicare Advantage risk score.

Is C81.44 a CC or MCC for inpatient DRG? +

Yes, this code is designated as CC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.

What CPT codes are commonly billed with C81.44? +

Procedures frequently paired with C81.44 include: Q5123, J9312, Q5115, Q5119, 38240.

What ICD-9 codes does C81.44 map to? +

Per CMS GEMs, C81.44 maps to ICD-9 codes: 20144. Useful for legacy data review and historical claim analysis.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on May 31, 2026.

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