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C81.33 ICD-10-CM Code: Lymphocyte depleted Hodgkin lymphoma, intra-abdominal lymph nodes

C81.33 maps to CMS-HCC V28 21. A source-labeled RAF reference is available. Confirm the documented diagnosis and applicable coding requirements. MEAT criteria · RAF Calculator · free HCC coding tools

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Code lookupC81.33

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

C81.33

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

Lymphocyte depleted Hodgkin lymphoma, intra-abdominal lymph nodes

A rare type of Hodgkin lymphoma (lymphocyte depleted variant) affecting lymph nodes in the abdomen.

Buddy the Bee presenting code insight

Buddy Insight

Lymphocyte depleted Hodgkin lymphoma with intra-abdominal lymph node involvement is a rare presentation pattern combining the most aggressive Hodgkin subtype with an infradiaphragmatic location.

CMS-HCC V28

HCC 21

Code-level coefficient reference

CMS-HCC V24

Historical

Historical

Not used for CY2026 payment

ACA/HHS

HCC 012

Code-level coefficient reference

ESRD/PACE

HCC 10

Code-level coefficient reference

RXHCC

HCC 21

Code-level coefficient reference

Inclusion Terms

Official
  • Lymphocyte depleted classical Hodgkin lymphomaInherited from C81.3

Excludes 2

Official
  • Kaposi's sarcoma of lymph nodes (C46.3)Inherited from C81-C96
  • secondary and unspecified neoplasm of lymph nodes (C77.-)Inherited from C81-C96
  • secondary neoplasm of bone marrow (C79.52)Inherited from C81-C96
  • secondary neoplasm of spleen (C78.89)Inherited from C81-C96

Includes

Official

No Includes notes are included in this display for C81.33. Check the code and parent instructions in the Code Book.

Excludes 1

Official
  • personal history of Hodgkin lymphoma (Z85.71)Inherited from C81

Code First

Official

No Code First sequencing instructions are included in this display for C81.33. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for C81.33. Check the code and parent instructions in the Code Book.

Code Also

Official

No Code Also instructions are included in this display for C81.33. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance
Pathology confirming lymphocyte depleted Hodgkin lymphoma subtype
Imaging documenting intra-abdominal lymph node involvement (mesenteric, para-aortic, retroperitoneal, or celiac nodes)
Distinction from intrapelvic nodes (below the pelvic brim) which require a different code
Ann Arbor staging with B-symptom documentation

MEAT Support

HCC Buddy guidance
Pathology confirming lymphocyte depleted Hodgkin lymphoma subtype
Imaging documenting intra-abdominal lymph node involvement (mesenteric, para-aortic, retroperitoneal, or celiac nodes)
Distinction from intrapelvic nodes (below the pelvic brim) which require a different code
Ann Arbor staging with B-symptom documentation

Audit Caution

HCC Buddy guidance
Confusing intra-abdominal with intrapelvic lymph nodes — review imaging to determine if nodes are above or below the pelvic brim
Grouping splenic involvement under intra-abdominal — the spleen has its own code (C81.37)
Defaulting to the unspecified code when abdominal CT or PET clearly identifies the nodal location
Not verifying the pathology subtype, particularly distinguishing lymphocyte depleted from mixed cellularity which can appear similar

Common Mistakes

HCC Buddy guidance
C81.36 — Lymphocyte depleted Hodgkin lymphoma, intrapelvic: the anatomic boundary between intra-abdominal and intrapelvic is the pelvic brim; para-aortic and mesenteric nodes are abdominal while iliac and obturator nodes are pelvic
C81.37 — Lymphocyte depleted Hodgkin lymphoma, spleen: splenic involvement has its own dedicated code separate from abdominal lymph node involvement
C81.23 — Mixed cellularity Hodgkin lymphoma, intra-abdominal: verify the histologic subtype before selecting the 5th character

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 C81.33 an HCC code?

Yes. C81.33 (Lymphocyte depleted Hodgkin lymphoma, intra-abdominal 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: C81.33 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
C81.33
Description
Lymphocyte depleted Hodgkin lymphoma, intra-abdominal 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 C81.33 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for C81.33

For C81.33, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.

  • 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

Coder workflow notes

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What This Code Means

C81.33 is the ICD-10-CM diagnosis code for lymphocyte depleted hodgkin lymphoma, intra-abdominal lymph nodes. A rare type of Hodgkin lymphoma (lymphocyte depleted variant) affecting lymph nodes in the abdomen. C81.33 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, C81.33 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 C81.33; use the applicable model and payment year when reviewing the V28 mapping. For CY2026 non-PACE Medicare Advantage, CMS uses 100% of the 2024 CMS-HCC model (V28). PACE uses a separate model blend. 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.

Ensure documentation specifies intra-abdominal lymph node involvement rather than other abdominal sites. For C81.33, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule. 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 C81.33 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Ensure documentation specifies intra-abdominal lymph node involvement rather than other abdominal sites
  • Distinguish from other lymphoma types that may also involve abdominal nodes

Clinical Significance

Lymphocyte depleted Hodgkin lymphoma with intra-abdominal lymph node involvement is a rare presentation pattern combining the most aggressive Hodgkin subtype with an infradiaphragmatic location. Abdominal involvement typically indicates at least stage II disease and may present with abdominal pain, weight loss, or hepatosplenomegaly. Treatment requires systemic chemotherapy with consideration of radiation to involved fields.

Documentation Requirements

  • Pathology confirming lymphocyte depleted Hodgkin lymphoma subtype
  • Imaging documenting intra-abdominal lymph node involvement (mesenteric, para-aortic, retroperitoneal, or celiac nodes)
  • Distinction from intrapelvic nodes (below the pelvic brim) which require a different code
  • Ann Arbor staging with B-symptom documentation
  • Provider assessment of the condition during the current encounter

Commonly Confused Codes

  • C81.36: Lymphocyte depleted Hodgkin lymphoma, intrapelvic: the anatomic boundary between intra-abdominal and intrapelvic is the pelvic brim; para-aortic and mesenteric nodes are abdominal while iliac and obturator nodes are pelvic
  • C81.37: Lymphocyte depleted Hodgkin lymphoma, spleen: splenic involvement has its own dedicated code separate from abdominal lymph node involvement
  • C81.23: Mixed cellularity Hodgkin lymphoma, intra-abdominal: verify the histologic subtype before selecting the 5th character

Child Codes

Code Hierarchy

C81.33 code history

Code setChange
FY2017 (effective Oct 1, 2016)Description revised

Source: official CMS ICD-10-CM order and addenda files, FY2016 through FY2027.

For C81.33, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.

C81.33 maps to CMS-HCC V28 category 21, Lymphoma and Other Cancers. See the ICD-10 to HCC mapping hub for how the V28 crosswalk works. The mapping identifies a payment HCC category for C81.33. Review its source-labeled HCC coefficient above, check the RAF Calculator with complete member context for CMS-HCC V28 PY2026, and confirm the documentation the chart needs before the code is submitted. HCC Buddy shows no RAF score unless every required source and calculation check passes.

Work C81.33 in HCC Buddy

Open C81.33 in the Code Book for the full Index-to-Tabular path, MEAT checklist, and V28 HCC mapping, or in the Encoder to code from a keyword search. Pro includes 7 days to try everything, no card required.