C81.09
BillableNodular lymphocyte predominant Hodgkin lymphoma, extranodal and solid organ sites
HCC Category Mapping
V28HCC 21 — Breast, Prostate, Colorectal and Other Cancers and Tumors
0.545V24HCC 10 — Lymphoma and Other Cancers
0.675ESRDHCC 10 — Lymphoma and Other Cancers
0.000RxHCCHCC 21 — Hodgkin Lymphoma and Other Cancers
0.000What This Code Means
Hodgkin lymphoma with nodular lymphocyte predominance that involves organs or tissues outside the lymph node system, such as the liver, lungs, or bone.
Coding Tips
- •Use this code for extranodal involvement (organs/tissues other than lymph nodes)
- •Document the specific extranodal site(s) involved in the clinical record for staging purposes
Clinical Significance
Nodular lymphocyte predominant Hodgkin lymphoma involving extranodal and solid organ sites indicates disease extending beyond the lymph node system into organs such as the liver, lungs, bone marrow, or other solid tissues. Extranodal involvement in NLPHL is uncommon and may indicate Stage IV disease or transformation to a more aggressive lymphoma. This presentation warrants thorough evaluation including consideration of large-cell transformation.
Documentation Requirements
- ✓Pathology confirming NLPHL subtype in the extranodal site
- ✓Specific extranodal organ(s) involved clearly documented
- ✓Biopsy of the extranodal site if possible to confirm NLPHL versus transformation to diffuse large B-cell lymphoma
- ✓Ann Arbor staging with 'E' suffix designation for extranodal extension
- ✓Bone marrow biopsy results
- ✓Assessment for large-cell transformation
Commonly Confused Codes
C81.07 — NLPHL, spleen: Splenic involvement has its own specific code; do not use C81.09 for the spleenC81.08 — NLPHL, multiple lymph node sites: Use for multiple nodal sites; C81.09 is specifically for extranodal/organ involvementC83.39 — Diffuse large B-cell lymphoma, extranodal: If NLPHL has transformed to DLBCL, code the transformation insteadC81.19 — Nodular sclerosis Hodgkin lymphoma, extranodal: Different subtype