C81.20
BillableMixed cellularity Hodgkin lymphoma, unspecified site
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
A type of Hodgkin lymphoma with mixed cellularity pattern (containing various cell types) at an unspecified location.
Coding Tips
- •Use this code only when the specific lymph node site is not documented; attempt to obtain site information for more specific coding
- •Requires seventh character for encounter type and remission status
Clinical Significance
Mixed cellularity Hodgkin lymphoma at an unspecified site is the second most common subtype of classic Hodgkin lymphoma, accounting for approximately 20-25% of cases. It is more common in older adults, males, and immunocompromised patients (particularly HIV-positive individuals) compared to nodular sclerosis. Mixed cellularity features a heterogeneous cellular background with classic Reed-Sternberg cells and is frequently associated with Epstein-Barr virus infection.
Documentation Requirements
- ✓Pathology report confirming mixed cellularity subtype with Reed-Sternberg cells
- ✓Immunohistochemistry (CD15+, CD30+, EBV status)
- ✓HIV testing status if not previously documented
- ✓Query provider for specific lymph node site to enable a more specific code
- ✓Ann Arbor staging including B-symptoms assessment
- ✓Treatment plan (ABVD or equivalent regimen)
Commonly Confused Codes
C81.10 — Nodular sclerosis Hodgkin lymphoma: Most common subtype; requires pathology to distinguish from mixed cellularityC81.21-C81.29 — Site-specific mixed cellularity codes: Use these when the lymph node location is documentedC81.00 — NLPHL: Completely different subtype with different immunophenotypeC81.40 — Lymphocyte-rich Hodgkin lymphoma: Less common subtype; pathology differentiates