C95.92
C95.92: Leukemia, unspecified, in relapse
Billable / specific codeICD-10-CM
C95.92 is a billable, specific ICD-10-CM code for leukemia, unspecified, in relapse. It is valid for submission on a claim.
Check C95.92 with the rest of the claim: free scrubberOther codes that can never be billed with C95.92
Their own Excludes1 notes name this code, so the conflict is not listed above.
- D72.825Bandemia
Risk adjustment
C95.92 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 22 Bladder, Colorectal, and Other Cancers0.363 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
C95.92 is named in 29 Medicare coverage policies: 27 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
- A52480Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) - Policy Article
- A52986Billing and Coding: Biomarkers for Oncology
Code history
Unchanged in every release from FY2024 to FY2027.