C94.02 — Acute erythroid leukemia, in relapse

Risk adjustment

C94.02 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:

• HCC 17 Cancer Metastatic to Lung, Liver, Brain, and Other Organs; Acute Myeloid Leukemia Except Promyelocytic4.209 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

C94.02 is named in 51 Medicare coverage policies — 49 listing it as supporting medical necessity, and 2 listing it as NOT covered. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

• A56462Billing and Coding: Erythropoiesis Stimulating Agents (ESA)not covered
• A60435Billing and Coding: Erythropoiesis Stimulating Agents (ESA)not covered
• 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