C84.04

C84.04: Mycosis fungoides, lymph nodes of axilla and upper limb

Billable / specific codeICD-10-CM

C84.04 is a billable, specific ICD-10-CM code for mycosis fungoides, lymph nodes of axilla and upper limb. It is valid for submission on a claim.

Check C84.04 with the rest of the claim: free scrubber

Excludes1 inherited from the categories above C84.04

A category’s note binds every code beneath it.

Written on C84.0: Mycosis fungoides

peripheral T-cell lymphoma, not elsewhere classified (C84.4-)

Written on C84: Mature T/NK-cell lymphomas

personal history of non-Hodgkin lymphoma (Z85.72)

Other codes that can never be billed with C84.04

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

C86Other specified types of T/NK-cell lymphoma
C82Follicular lymphoma
C83.0Small cell B-cell lymphoma
C83.3Diffuse large B-cell lymphoma

Risk adjustment

C84.04 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:

HCC 20 Lung and Other Severe Cancers1.136 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

C84.04 is named in 38 Medicare coverage policies: 38 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
A55717Billing and Coding: Lab: Flow Cytometry

Code history

Unchanged in every release from FY2024 to FY2027.