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

ICD-10 C84.9A

Billable / Specific HCC v28: 10 CC

Mature T/NK-cell lymphomas, unspecified, in remission

C84
Block
0
Synonyms
325
LCDs
17
Payer Policies
0
Linked CPTs

About ICD-10-CM C84.9A

ICD-10-CM code C84.9A represents Mature T/NK-cell lymphomas, unspecified, in remission. This is a billable/specific code in the chapter (block C84). The 2026 edition of ICD-10-CM C84.9A became effective on October 1, 2025.

Coding Tips for C84.9A

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

HCC capture: document with MEAT each year

C84.9A 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

C84.9A 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 Mature T/NK-cell lymphomas, unspecified, in remission. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.

Medicare LCD Coverage for C84.9A

Local Coverage Determinations (LCDs) from CMS MACs that list C84.9A as a covered diagnosis.

325 LCDs

Showing top 10 of 325 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74170 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74177 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74160 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74178 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74150 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 72194 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74176 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 72192 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 72193 →
CMS LCD: Billing and Coding: MolDX: Lab-Developed Tests for Inherited Cancer Syndromes in Patients with Cancer
Article ID: 58679, Effective: 2026-02-05 00:00:00, 1346 covered, 0 non-covered
CPT 81215 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing C84.9A.

17 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: Lab: Flow Cytometry
Policy ID: ART-55717
Billing and Coding: Rituximab
Policy ID: ART-56380
Billing and Coding: Upper Gastrointestinal Endoscopy and Visualization
Policy ID: ART-56389

CPT Codes Commonly Billed with C84.9A

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

No procedure linkages on file for C84.9A

We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.

Codes Adjacent To C84.9A

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 C84.9A, Billing FAQ

Is ICD-10 code C84.9A billable? +

Yes, C84.9A is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

Does C84.9A affect Medicare Advantage HCC risk adjustment? +

Yes. C84.9A maps to CMS-HCC v28 category 10. Capture this diagnosis annually for accurate Medicare Advantage risk score.

Is C84.9A 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.

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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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