C94.30: Mast cell leukemia not having achieved remission
C94.30 is a billable, specific ICD-10-CM code for mast cell leukemia not having achieved remission. It is valid for submission on a claim.
Check C94.30 with the rest of the claim: free scrubberInclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Mast cell leukemia with failed remission
- Mast cell leukemia NOS
Other codes that can never be billed with C94.30
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
C94.30 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
C94.30 is named in 32 Medicare coverage policies: 30 listing it as supporting medical necessity, and 2 listing it as NOT covered. Which one applies depends on your Medicare contractor.
- A56462Billing and Coding: Erythropoiesis Stimulating Agents (ESA)not covered
- A60435Billing and Coding: Erythropoiesis Stimulating Agents (ESA)not covered
- A52370Billing and Coding: Bevacizumab and biosimilars
- A52480Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) - Policy Article
Code history
Unchanged in every release from FY2024 to FY2027.