C81.02 maps to CMS-HCC V28 21. A source-labeled RAF reference is available. Confirm the documented diagnosis and applicable coding requirements. MEAT criteria · RAF Calculator · HCC coding software

ICD-10-CM Code View

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Code lookupC81.02

Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Neoplasms (C00-D49) / Malignant neoplasms of lymphoid, hematopoietic and related tissue (C81-C96)

C81.02

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Nodular lymphocyte predominant Hodgkin lymphoma, intrathoracic lymph nodes

A specific type of Hodgkin lymphoma affecting the lymph nodes inside the chest cavity.

Buddy Insight

Nodular lymphocyte predominant Hodgkin lymphoma involving intrathoracic lymph nodes is less common than cervical presentation for this subtype.

Overview Risk Models Code Book Documentation Audit Notes Edition comparison

CMS-HCC V28

Mapped

HCC 21

Lymphoma and Other Cancers

Coefficient HCC 21: 0.671 (Community Non-Dual Aged (CNA))

CMS-HCC V24

Historical

Not used for standard CY2026 Medicare Advantage payment. Select a historical period to review V24.

Not used for CY2026 payment

ACA/HHS

Mapped

HCC 012

HHS-HCC 012 adult, RAF varies...

Code-level coefficient reference

ESRD/PACE

Mapped

HCC 10

Lymphoma and Other Cancers

Code-level coefficient reference

RXHCC

Mapped

HCC 21

Lymphomas and Other Hematolog...

Code-level coefficient reference

Code Book Path

Official

C81Hodgkin lymphoma C81.0Nodular lymphocyte predominant Hodgkin lymphoma C81.02Nodular lymphocyte predominant Hodgkin lymphoma, intrathoracic lymph nodes

Inclusion Terms

Official

No inclusion terms are included in this display for C81.02. Check the code and parent instructions in the Code Book.

Excludes 2

Official

Kaposi's sarcoma of lymph nodes (C46.3)Inherited from C81-C96
secondary and unspecified neoplasm of lymph nodes (C77.-)Inherited from C81-C96
secondary neoplasm of bone marrow (C79.52)Inherited from C81-C96
secondary neoplasm of spleen (C78.89)Inherited from C81-C96

Related Codes

Official

C81.00Nodular lymphocyte predominant Hodgkin lymphoma, unspecified site C81.01Nodular lymphocyte predominant Hodgkin lymphoma, lymph nodes of head, face, and neck C81.03Nodular lymphocyte predominant Hodgkin lymphoma, intra-abdominal lymph nodes C81.04Nodular lymphocyte predominant Hodgkin lymphoma, lymph nodes of axilla and upper limb C81.05Nodular lymphocyte predominant Hodgkin lymphoma, lymph nodes of inguinal region and lower limb

Includes

Official

No Includes notes are included in this display for C81.02. Check the code and parent instructions in the Code Book.

Excludes 1

Official

personal history of Hodgkin lymphoma (Z85.71)Inherited from C81

Code First

Official

No Code First sequencing instructions are included in this display for C81.02. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for C81.02. Check the code and parent instructions in the Code Book.

Code Also

Official

No Code Also instructions are included in this display for C81.02. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance

Pathology confirming NLPHL subtype (not nodular sclerosis, which is more common in the mediastinum)

Imaging (CT chest, PET/CT) confirming intrathoracic lymph node involvement

Specific intrathoracic lymph node stations involved (mediastinal, hilar, etc.)

Assessment for airway compression or superior vena cava syndrome

MEAT Support

HCC Buddy guidance

Pathology confirming NLPHL subtype (not nodular sclerosis, which is more common in the mediastinum)

Imaging (CT chest, PET/CT) confirming intrathoracic lymph node involvement

Specific intrathoracic lymph node stations involved (mediastinal, hilar, etc.)

Assessment for airway compression or superior vena cava syndrome

Audit Caution

HCC Buddy guidance

Defaulting to nodular sclerosis Hodgkin lymphoma for mediastinal disease without pathologic confirmation — NLPHL can also involve intrathoracic nodes

Using the unspecified site code when intrathoracic involvement is documented on imaging

Not distinguishing between intrathoracic lymph nodes and lung parenchymal involvement (extranodal)

Missing the uncommon nature of intrathoracic NLPHL, which should prompt pathology review to confirm the subtype

Common Mistakes

HCC Buddy guidance

C81.12 — Nodular sclerosis Hodgkin lymphoma, intrathoracic: Nodular sclerosis is far more common in the mediastinum; careful pathologic distinction required

C81.00 — NLPHL, unspecified site: Use C81.02 when intrathoracic involvement is confirmed

C85.12 — Unspecified B-cell lymphoma, intrathoracic: NLPHL has its own specific code

C83.12 — Diffuse large B-cell lymphoma, intrathoracic: Different entity unless NLPHL has transformed

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Is C81.02 an HCC code?

Yes. C81.02 (Nodular lymphocyte predominant Hodgkin lymphoma, intrathoracic lymph nodes) maps to HCC 21, Lymphoma and Other Cancers under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 0.671. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes. It is billable for payment year 2026.

Coder answer: C81.02 is billable and maps to V28 HCC 21, Lymphoma and Other Cancers. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code: C81.02
Description: Nodular lymphocyte predominant Hodgkin lymphoma, intrathoracic lymph nodes
HCC (V28): HCC 21 — Lymphoma and Other Cancers
RAF reference coefficient: 0.671
Billable: Yes
Payment year: 2026

HCC Category Mapping

V28HCC 21, Lymphoma and Other Cancers

0.671

ESRDHCC 10, Lymphoma and Other Cancers

Not separately weighted

RxHCCHCC 21, Lymphomas and Other Hematologic Cancers

Not separately weighted

These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. Weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.

Work C81.02 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for C81.02

For C81.02, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.

MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
EEvaluate: test results, medication response, or physical findings reviewed by the provider
AAssess: explicit mention in the assessment or plan with acknowledgment of status
TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis

Coder workflow notes

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What This Code Means

C81.02 is the ICD-10-CM diagnosis code for nodular lymphocyte predominant hodgkin lymphoma, intrathoracic lymph nodes. A specific type of Hodgkin lymphoma affecting the lymph nodes inside the chest cavity. C81.02 sits in the ICD-10-CM chapter for neoplasms (c00-d49), within the section covering malignant neoplasms of lymphoid, hematopoietic and related tissue (c81-c96).

Under the CMS-HCC V28 risk adjustment model, C81.02 maps to Lymphoma and Other Cancers (HCC 21) with a source-labeled community, non-dual, aged reference coefficient of 0.671. For CY2026 non-PACE Medicare Advantage, CMS uses 100% of the 2024 CMS-HCC model (V28). PACE uses a separate model blend. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes.

Ensure documentation clearly indicates intrathoracic (chest) lymph node involvement. For C81.02, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.

HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for C81.02 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Ensure documentation clearly indicates intrathoracic (chest) lymph node involvement
•Distinguish from mediastinal involvement; verify exact anatomical location in imaging reports

Clinical Significance

Nodular lymphocyte predominant Hodgkin lymphoma involving intrathoracic lymph nodes is less common than cervical presentation for this subtype. Intrathoracic involvement may indicate more advanced disease and potentially affects staging and treatment decisions. Mediastinal lymphadenopathy in NLPHL is less typical compared to classic nodular sclerosis Hodgkin lymphoma, which has a strong predilection for the mediastinum.

Documentation Requirements

✓Pathology confirming NLPHL subtype (not nodular sclerosis, which is more common in the mediastinum)
✓Imaging (CT chest, PET/CT) confirming intrathoracic lymph node involvement
✓Specific intrathoracic lymph node stations involved (mediastinal, hilar, etc.)
✓Assessment for airway compression or superior vena cava syndrome
✓Ann Arbor staging with documentation of whether disease is limited or advanced

Commonly Confused Codes

•C81.12: Nodular sclerosis Hodgkin lymphoma, intrathoracic: Nodular sclerosis is far more common in the mediastinum; careful pathologic distinction required
•C81.00: NLPHL, unspecified site: Use C81.02 when intrathoracic involvement is confirmed
•C85.12: Unspecified B-cell lymphoma, intrathoracic: NLPHL has its own specific code
•C83.12: Diffuse large B-cell lymphoma, intrathoracic: Different entity unless NLPHL has transformed