C81.09

C81.09: Nodular lymphocyte predominant Hodgkin lymphoma, extranodal and solid organ sites

Billable / specific codeICD-10-CM

C81.09 is a billable, specific ICD-10-CM code for nodular lymphocyte predominant hodgkin lymphoma, extranodal and solid organ sites. It is valid for submission on a claim.

Check C81.09 with the rest of the claim: free scrubber

Excludes1 inherited from the categories above C81.09

A category’s note binds every code beneath it.

Written on C81: Hodgkin lymphoma

personal history of Hodgkin lymphoma (Z85.71)

Other codes that can never be billed with C81.09

Their own Excludes1 notes name this code, so the conflict is not listed above.

C26.1Malignant neoplasm of spleen

Risk adjustment

C81.09 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:

HCC 21 Lymphoma and Other Cancers0.671 RAF

Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score. Look up the whole chart to see which of its HCCs the hierarchy would zero.

Medicare coverage

C81.09 is named in 42 Medicare coverage policies: 42 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A52479Oral Anticancer Drugs - Policy Article
A52480Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) - Policy Article
A54768Billing and Coding: Cardiac Blood Pool Imaging (Multiple Gated Acquisition Scanning- MUGA, Ventriculography) When Performed in Conjunction with Cardiotoxic Chemotherapy
A55336Billing and Coding: Retroperitoneal Ultrasound

Code history

Unchanged in every release from FY2024 to FY2027.