C81.37
BillableLymphocyte depleted Hodgkin lymphoma, spleen
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
This is a type of Hodgkin lymphoma (a cancer of the lymph system) where there are very few lymphocytes (infection-fighting white blood cells) present, and the cancer is located in the spleen. This is a rare and aggressive form of Hodgkin lymphoma.
Coding Tips
- •Verify the histological subtype is confirmed as 'lymphocyte depleted' in the pathology report before assigning this code
- •Ensure documentation specifies the spleen as the primary site; if multiple sites are involved, use additional codes for each anatomical location
Clinical Significance
Lymphocyte depleted Hodgkin lymphoma with splenic involvement is a grave prognostic indicator combining the most aggressive Hodgkin subtype with extranodal organ involvement. Splenic disease elevates the stage to at least stage III and may be associated with bone marrow involvement. This presentation drives high utilization including possible splenectomy, intensive chemotherapy, and frequent surveillance imaging.
Documentation Requirements
- ✓Pathology confirming lymphocyte depleted Hodgkin lymphoma histology
- ✓Imaging or surgical pathology confirming splenic involvement (not just splenomegaly without confirmed infiltration)
- ✓Bone marrow biopsy results to rule out concurrent marrow involvement
- ✓Stage III or higher Ann Arbor designation
- ✓Documentation of active treatment or surveillance during the encounter
Commonly Confused Codes
C81.33 — Lymphocyte depleted Hodgkin lymphoma, intra-abdominal: splenic involvement is coded separately from abdominal lymph node disease; the spleen is a distinct organC81.39 — Lymphocyte depleted Hodgkin lymphoma, extranodal/solid organ: use C81.37 specifically for the spleen; C81.39 is for other extranodal sitesC81.27 — Mixed cellularity Hodgkin lymphoma, spleen: same organ but different histologic subtypeD73.1 — Hypersplenism: functional spleen disorder, not neoplastic involvement
Code Hierarchy
└C81Hodgkin lymphoma└C81.3Lymphocyte depleted Hodgkin lymphoma└C81.37Lymphocyte depleted Hodgkin lymphoma, spleen
└C81.37Lymphocyte depleted Hodgkin lymphoma, spleen