C81.12
BillableNodular sclerosis Hodgkin lymphoma, intrathoracic lymph nodes
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
Nodular sclerosis Hodgkin lymphoma involving the lymph nodes within the chest cavity (mediastinal and other intrathoracic nodes).
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 hereC81.10 — Nodular sclerosis Hodgkin lymphoma, unspecified site: Use C81.12 when mediastinal/intrathoracic involvement is documentedC85.22 — Mediastinal (thymic) large B-cell lymphoma, intrathoracic: Different lymphoma subtype that also presents as mediastinal massC38.3 — Malignant neoplasm of mediastinum, part unspecified: Not appropriate for lymphoma coding
Code Hierarchy
└C81Hodgkin lymphoma└C81.1Nodular sclerosis Hodgkin lymphoma└C81.12Nodular sclerosis Hodgkin lymphoma, intrathoracic lymph nodes
└C81.12Nodular sclerosis Hodgkin lymphoma, intrathoracic lymph nodes