C95.00 — Acute leukemia of unspecified cell type not having achieved remission
C95.00 is a billable, specific ICD-10-CM code for acute leukemia of unspecified cell type 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.
- Acute leukemia of unspecified cell type with failed remission
- Acute leukemia NOS
Excludes1 inherited from the categories above C95.00
These are not written on C95.00, but they bind it: a note on a category applies to every code beneath it. Billing C95.00 with anything listed here is a denial.
Other codes that can never be billed with C95.00
These codes carry an Excludes1 note pointing at C95.00. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading C95.00 alone.
- D72.825Bandemia
Risk adjustment
C95.00 risk-adjusts. Under the CMS-HCC V28 model it maps to these categories:
- HCC 18 Cancer Metastatic to Bone, Other and Unspecified Metastatic Cancer; Acute Leukemia Except Myeloid2.341 RAF
- HCC 18 Cancer Metastatic to Bone, Other and Unspecified Metastatic Cancer; Acute Leukemia Except Myeloid2.341 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
C95.00 is named in 47 Medicare coverage policies — 45 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
Code history
C95.00 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 C95.0. If C95.00 is not quite right, the correct code is usually one of these.
Questions about C95.00
- Is C95.00 a billable ICD-10-CM code?
- Yes. C95.00 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does C95.00 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 C95.00?
- C95.00 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 C95.00 (C95.0, C95) and apply to it just the same.