C96.9 — Malignant neoplasm of lymphoid, hematopoietic and related tissue, unspecified
C96.9 is a billable, specific ICD-10-CM code for malignant neoplasm of lymphoid, hematopoietic and related tissue, unspecified. It is valid for submission on a claim.
Other codes that can never be billed with C96.9
These codes carry an Excludes1 note pointing at C96.9. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading C96.9 alone.
- D76Other specified diseases with participation of lymphoreticular and reticulohistiocytic tissue
Risk adjustment
C96.9 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.
Medicare coverage
C96.9 is named in 35 Medicare coverage policies — 35 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A52450Billing and Coding: Paclitaxel (e.g., Taxol®/Abraxane ™)
- A52479Oral Anticancer Drugs - Policy Article
- A52479Oral Anticancer Drugs - Policy Article
- A52479Oral Anticancer Drugs - Policy Article
Related codes at this level
Codes that share C96. If C96.9 is not quite right, the correct code is usually one of these.
- C96.0Multifocal and multisystemic (disseminated) Langerhans-cell histiocytosis
- C96.2Malignant mast cell neoplasm
- C96.4Sarcoma of dendritic cells (accessory cells)
- C96.5Multifocal and unisystemic Langerhans-cell histiocytosis
- C96.6Unifocal Langerhans-cell histiocytosis
- C96.AHistiocytic sarcoma
- C96.ZOther specified malignant neoplasms of lymphoid, hematopoietic and related tissue
Questions about C96.9
- Is C96.9 a billable ICD-10-CM code?
- Yes. C96.9 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does C96.9 sit in the tabular list?
- Neoplasms (C00-D49), in the block Malignant neoplasms of lymphoid, hematopoietic and related tissue (C81-C96).