C81.28
BillableMixed cellularity Hodgkin lymphoma, lymph nodes of multiple 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
A type of Hodgkin lymphoma with mixed cellularity affecting lymph nodes in multiple different areas of the body.
Coding Tips
- •Use this code only when lymph nodes in multiple distinct sites are involved
- •Document all affected sites for complete clinical picture and staging purposes
Clinical Significance
Mixed cellularity Hodgkin lymphoma involving lymph nodes of multiple sites indicates disseminated disease, typically corresponding to advanced-stage (III or IV) Ann Arbor classification. Multi-site involvement drives higher treatment intensity with combination chemotherapy regimens and potentially radiation to multiple fields. This code reflects substantial resource utilization and ongoing care complexity.
Documentation Requirements
- ✓Pathology confirming mixed cellularity classical Hodgkin lymphoma
- ✓Imaging documenting involvement of at least two distinct lymph node regions (e.g., cervical and mediastinal, or axillary and inguinal)
- ✓Specific identification of each involved nodal region in the clinical documentation
- ✓Ann Arbor staging with documentation of all involved sites
- ✓Current treatment phase and disease status during the encounter
Commonly Confused Codes
C81.20 — Mixed cellularity Hodgkin lymphoma, unspecified site: use C81.28 when multiple specific sites are documented rather than defaulting to unspecifiedC81.29 — Mixed cellularity Hodgkin lymphoma, extranodal sites: C81.28 is for multiple lymph node regions; C81.29 is for spread to organs outside the lymph node systemC81.21-C81.26 — Site-specific mixed cellularity codes: when only one nodal region is involved, use the specific single-site code rather than the multiple sites code
Code Hierarchy
└C81Hodgkin lymphoma└C81.2Mixed cellularity Hodgkin lymphoma└C81.28Mixed cellularity Hodgkin lymphoma, lymph nodes of multiple sites
└C81.28Mixed cellularity Hodgkin lymphoma, lymph nodes of multiple sites