C94.80 — Other specified leukemias not having achieved remission
C94.80 is a billable, specific ICD-10-CM code for other specified leukemias not having achieved remission. It is valid for submission on a claim.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Other specified leukemia with failed remission
- Other specified leukemias NOS
Risk adjustment
C94.80 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.
Medicare coverage
C94.80 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
Related codes at this level
Codes that share C94.8. If C94.80 is not quite right, the correct code is usually one of these.
Questions about C94.80
- Is C94.80 a billable ICD-10-CM code?
- Yes. C94.80 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does C94.80 sit in the tabular list?
- Neoplasms (C00-D49), in the block Malignant neoplasms of lymphoid, hematopoietic and related tissue (C81-C96).