ICD-10 C92.Z1
Billable / Specific HCC v28: 9 CCOther myeloid leukemia, in remission
About ICD-10-CM C92.Z1
ICD-10-CM code C92.Z1 represents Other myeloid leukemia, in remission. This is a billable/specific code in the chapter (block C92). The 2026 edition of ICD-10-CM C92.Z1 became effective on October 1, 2025.
Coding Tips for C92.Z1
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
C92.Z1 is a CMS-HCC v28 risk-adjustment code (category 9). 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.
C92.Z1 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
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 Other myeloid leukemia, in remission. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.
Medicare LCD Coverage for C92.Z1
Local Coverage Determinations (LCDs) from CMS MACs that list C92.Z1 as a covered diagnosis.
Showing top 10 of 389 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing C92.Z1.
5 Medicare
CPT Codes Commonly Billed with C92.Z1
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 81450 CMS LCD: Billing and Coding: MolDX: Next-Generation Sequencing Lab-Developed Tests for Myeloid Malignancies and Suspected Myeloid Malignancies CMS LCD
- 81451 CMS LCD: Billing and Coding: MolDX: Next-Generation Sequencing Lab-Developed Tests for Myeloid Malignancies and Suspected Myeloid Malignancies CMS LCD
Convert C92.Z1 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| C92.Z1 | 20581 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To C92.Z1
Other codes in section C81-C96 (Malignant neoplasms of lymphoid, hematopoietic and related tissue).
ICD-10 C92.Z1, Billing FAQ
Is ICD-10 code C92.Z1 billable? +
Yes, C92.Z1 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
Does C92.Z1 affect Medicare Advantage HCC risk adjustment? +
Yes. C92.Z1 maps to CMS-HCC v28 category 9. Capture this diagnosis annually for accurate Medicare Advantage risk score.
Is C92.Z1 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 C92.Z1? +
Procedures frequently paired with C92.Z1 include: 81450, 81451.
What ICD-9 codes does C92.Z1 map to? +
Per CMS GEMs, C92.Z1 maps to ICD-9 codes: 20581. 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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