What is ICD-10 code C81.12?

C81.12 is the ICD-10-CM diagnosis code for Nodular sclerosis Hodgkin lymphoma, intrathoracic lymph nodes. Nodular sclerosis Hodgkin lymphoma involving the lymph nodes within the chest cavity (mediastinal and other intrathoracic nodes). It belongs to the ICD-10-CM chapter for neoplasms (c00-d49). C81.12 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. C81.12 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. C81.12 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. C81.12 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

Which HCC does C81.12 map to under V28?

C81.12 maps to CMS-HCC V28 HCC 21 (Lymphoma and Other Cancers). The category numbers, labels, and conditions come from the CMS-HCC V28 model file for payment year 2026.

2026 ICD-10-CM C81.12: Nodular sclerosis Hodgkin

C81.12 maps to CMS-HCC V28 21. A source-labeled RAF reference is available. Documentation must support MEAT. MEAT criteria · RAF Calculator · free HCC coding tools

ICD-10-CM Code View

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Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.

Code lookupC81.12Effective periodFY2026 Apr Update (Apr 1-Sep 30)

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

C81.12

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

Nodular sclerosis Hodgkin lymphoma, intrathoracic lymph nodes

Nodular sclerosis Hodgkin lymphoma involving the lymph nodes within the chest cavity (mediastinal and other intrathoracic nodes).

Buddy Insight

Nodular sclerosis Hodgkin lymphoma of intrathoracic lymph nodes is one of the most characteristic presentations of this subtype, as nodular sclerosis has a strong predilection for the mediastinum.

CMS-HCC V28

Mapped

HCC 21

Lymphoma and Other Cancers

Code-level coefficient reference

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

C81.1Nodular sclerosis Hodgkin lymphoma

C81.12Nodular sclerosis Hodgkin lymphoma, intrathoracic lymph nodes

Inclusion Terms

Official

Nodular sclerosis classical Hodgkin lymphoma

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for C81.12 in this effective period.

Related Child Codes

Official

C81.10Nodular sclerosis Hodgkin lymphoma, unspecified site

C81.11Nodular sclerosis Hodgkin lymphoma, lymph nodes of head, face, and neck

C81.13Nodular sclerosis Hodgkin lymphoma, intra-abdominal lymph nodes

C81.14Nodular sclerosis Hodgkin lymphoma, lymph nodes of axilla and upper limb

C81.15Nodular sclerosis Hodgkin lymphoma, lymph nodes of inguinal region and lower limb

Includes

Official

ICD-10-CM does not list Includes notes for C81.12 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for C81.12 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for C81.12 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for C81.12 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for C81.12 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Pathology confirming nodular sclerosis subtype

Chest imaging (CT, PET/CT) documenting intrathoracic lymphadenopathy

Assessment for bulky disease (mass greater than 10 cm or greater than one-third thoracic diameter)

Evaluation for airway compression, pleural effusion, or superior vena cava syndrome

MEAT Support

HCC Buddy guidance

Pathology confirming nodular sclerosis subtype

Chest imaging (CT, PET/CT) documenting intrathoracic lymphadenopathy

Assessment for bulky disease (mass greater than 10 cm or greater than one-third thoracic diameter)

Evaluation for airway compression, pleural effusion, or superior vena cava syndrome

Audit Caution

HCC Buddy guidance

Using unspecified site when imaging clearly shows mediastinal lymphadenopathy

Confusing primary mediastinal large B-cell lymphoma with nodular sclerosis Hodgkin lymphoma — both present as anterior mediastinal masses but are different entities

Not documenting bulky disease status, which affects treatment decisions and prognosis

Failing to note that mediastinal plus cervical disease requires C81.18 (multiple sites)

Common Mistakes

HCC Buddy guidance

C81.02 — NLPHL, intrathoracic: Less common subtype in the mediastinum; nodular sclerosis is far more typical here

C81.10 — Nodular sclerosis Hodgkin lymphoma, unspecified site: Use C81.12 when mediastinal/intrathoracic involvement is documented

C85.22 — Mediastinal (thymic) large B-cell lymphoma, intrathoracic: Different lymphoma subtype that also presents as mediastinal mass

C38.3 — Malignant neoplasm of mediastinum, part unspecified: Not appropriate for lymphoma coding

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 C81.12 an HCC code?

Yes. C81.12 (Nodular sclerosis 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: C81.12 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: C81.12
Description: Nodular sclerosis 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 C81.12 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT Criteria for C81.12

For C81.12 to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically, it has to be re-documented and supported each calendar year.

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

Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed C81.12 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

C81.12 is the ICD-10-CM diagnosis code for nodular sclerosis hodgkin lymphoma, intrathoracic lymph nodes. Nodular sclerosis Hodgkin lymphoma involving the lymph nodes within the chest cavity (mediastinal and other intrathoracic nodes). C81.12 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, C81.12 maps to Lymphoma and Other Cancers (HCC 21) with a source-labeled community, non-dual, aged reference coefficient of 0.671. No V24 mapping is shown for C81.12; use the applicable model and payment year when reviewing the V28 mapping. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition. 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.

Confirm intrathoracic location is documented; this includes mediastinal and other chest lymph nodes. Because C81.12 maps to an HCC category, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) before the diagnosis is used for risk adjustment. 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 C81.12 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Confirm intrathoracic location is documented; this includes mediastinal and other chest lymph nodes
•Intrathoracic involvement is common in nodular sclerosis type and often requires imaging confirmation

Clinical Significance

Nodular sclerosis Hodgkin lymphoma of intrathoracic lymph nodes is one of the most characteristic presentations of this subtype, as nodular sclerosis has a strong predilection for the mediastinum. Mediastinal mass is the hallmark finding, sometimes causing superior vena cava syndrome, cough, or dyspnea. This presentation is especially common in young women. Bulky mediastinal disease (greater than one-third of thoracic diameter) is a prognostic factor that influences treatment intensity.

Documentation Requirements

✓Pathology confirming nodular sclerosis subtype
✓Chest imaging (CT, PET/CT) documenting intrathoracic lymphadenopathy
✓Assessment for bulky disease (mass greater than 10 cm or greater than one-third thoracic diameter)
✓Evaluation for airway compression, pleural effusion, or superior vena cava syndrome
✓Documentation of symptoms related to mediastinal mass
✓Response assessment plan with interim PET/CT

Commonly Confused Codes

•C81.02: NLPHL, intrathoracic: Less common subtype in the mediastinum; nodular sclerosis is far more typical here
•C81.10: Nodular sclerosis Hodgkin lymphoma, unspecified site: Use C81.12 when mediastinal/intrathoracic involvement is documented
•C85.22: Mediastinal (thymic) large B-cell lymphoma, intrathoracic: Different lymphoma subtype that also presents as mediastinal mass
•C38.3: Malignant neoplasm of mediastinum, part unspecified: Not appropriate for lymphoma coding