Is C81.42 a billable ICD-10-CM code?

Yes. C81.42 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does C81.42 sit in the tabular list?

Neoplasms (C00-D49), in the block Malignant neoplasms of lymphoid, hematopoietic and related tissue (C81-C96).

What cannot be coded together with C81.42?

C81.42 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above C81.42 (C81.4, C81) and apply to it just the same.

C81.42

C81.42 — Lymphocyte-rich Hodgkin lymphoma, intrathoracic lymph nodes

Billable / specific codeICD-10-CM

C81.42 is a billable, specific ICD-10-CM code for lymphocyte-rich hodgkin lymphoma, intrathoracic lymph nodes. It is valid for submission on a claim.

Excludes1 inherited from the categories above C81.42

These are not written on C81.42, but they bind it: a note on a category applies to every code beneath it. Billing C81.42 with anything listed here is a denial.

Written on C81.4 — Lymphocyte-rich Hodgkin lymphoma

nodular lymphocyte predominant Hodgkin lymphoma (C81.0-)

Written on C81 — Hodgkin lymphoma

personal history of Hodgkin lymphoma (Z85.71)

Other codes that can never be billed with C81.42

These codes carry an Excludes1 note pointing at C81.42. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading C81.42 alone.

C26.1Malignant neoplasm of spleen

Risk adjustment

C81.42 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.

Medicare coverage

C81.42 is named in 55 Medicare coverage policies — 55 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

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Code history

C81.42 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share C81.4. If C81.42 is not quite right, the correct code is usually one of these.

Questions about C81.42

Is C81.42 a billable ICD-10-CM code?: Yes. C81.42 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does C81.42 sit in the tabular list?: Neoplasms (C00-D49), in the block Malignant neoplasms of lymphoid, hematopoietic and related tissue (C81-C96).
What cannot be coded together with C81.42?: C81.42 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above C81.42 (C81.4, C81) and apply to it just the same.