C96.5: Multifocal and unisystemic Langerhans-cell histiocytosis
C96.5 is a billable, specific ICD-10-CM code for multifocal and unisystemic langerhans-cell histiocytosis. It is valid for submission on a claim.
Check C96.5 with the rest of the claim: free scrubberExcludes1: never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Hand-Schüller-Christian disease
- Histiocytosis X, multifocal
Excludes1 inherited from the categories above C96.5
A category’s note binds every code beneath it.
Other codes that can never be billed with C96.5
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
C96.5 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 21 Lymphoma and Other Cancers0.671 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
C96.5 is named in 16 Medicare coverage policies: 16 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A54768Billing and Coding: Cardiac Blood Pool Imaging (Multiple Gated Acquisition Scanning- MUGA, Ventriculography) When Performed in Conjunction with Cardiotoxic Chemotherapy
- A56421Billing and Coding: CT of the Abdomen and Pelvis
- A57224Billing and Coding: Respiratory Care
- A57630Billing and Coding: Percutaneous Vertebral Augmentation (PVA) for Vertebral Compression Fracture (VCF)
Alphabetic index entries that lead here
- Hand-Schüller-Christian disease or syndrome
- Schüller-Christian disease or syndrome
- Syndrome›Schüller-Christian
- Xanthoma›bone(generalisata)
- Histiocytosis›X NEC›multifocal
- Histiocytosis›Langerhans' cell NEC›multifocal X›unisystemic
Code history
Unchanged in every release from FY2024 to FY2027.
Other codes under C96
- C96.0Multifocal and multisystemic (disseminated) Langerhans-cell histiocytosis
- C96.2Malignant mast cell neoplasm
- C96.4Sarcoma of dendritic cells (accessory cells)
- C96.6Unifocal Langerhans-cell histiocytosis
- C96.AHistiocytic sarcoma
- C96.ZOther specified malignant neoplasms of lymphoid, hematopoietic and related tissue
- C96.9Malignant neoplasm of lymphoid, hematopoietic and related tissue, unspecified