What is ICD-10 code C81.38?

C81.38 is the ICD-10-CM diagnosis code for Lymphocyte depleted Hodgkin lymphoma, lymph nodes of multiple sites. It belongs to the ICD-10-CM chapter for neoplasms (c00-d49). C81.38 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. C81.38 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. C81.38 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. C81.38 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

Which HCC does C81.38 map to under V28?

C81.38 maps to CMS-HCC V28 HCC 21 (Lymphoma and Other Cancers). The category numbers, labels, and conditions come from the CMS-HCC V28 model file for payment year 2026.

2026 ICD-10-CM C81.38: Lymphocyte depleted Hodgkin

C81.38 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 · HCC coding software

ICD-10-CM Code View

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Code lookupC81.38

Effective periodFY2026 Apr Update (Apr 1-Sep 30)

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

C81.38

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

Lymphocyte depleted Hodgkin lymphoma, lymph nodes of multiple sites

This is a type of Hodgkin lymphoma (a cancer of the lymph system) where there are very few lymphocytes (a type of white blood cell) present, and the cancer is found in lymph nodes in multiple locations throughout the body. This is a rare and aggressive form of Hodgkin lymphoma.

Buddy Insight

Lymphocyte depleted Hodgkin lymphoma affecting multiple lymph node sites represents widespread dissemination of the most aggressive classical Hodgkin subtype.

Overview Risk Models Code Book Documentation Audit Notes Edition comparison

CMS-HCC V28

Mapped

HCC 21

Lymphoma and Other Cancers

Code-level coefficient reference

CMS-HCC V24

Historical

Not used for standard CY2026 Medicare Advantage payment. Select a historical period to review V24.

Not used for CY2026 payment

ACA/HHS

Mapped

HCC 012

HHS-HCC 012 adult, RAF varies...

Code-level coefficient reference

ESRD/PACE

Mapped

HCC 10

Lymphoma and Other Cancers

Code-level coefficient reference

RXHCC

Mapped

HCC 21

Lymphomas and Other Hematolog...

Code-level coefficient reference

Code Book Path

Official

C81Hodgkin lymphoma C81.3Lymphocyte depleted Hodgkin lymphoma C81.38Lymphocyte depleted Hodgkin lymphoma, lymph nodes of multiple sites

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

Related Codes

Official

C81.30Lymphocyte depleted Hodgkin lymphoma, unspecified site C81.31Lymphocyte depleted Hodgkin lymphoma, lymph nodes of head, face, and neck C81.32Lymphocyte depleted Hodgkin lymphoma, intrathoracic lymph nodes C81.33Lymphocyte depleted Hodgkin lymphoma, intra-abdominal lymph nodes C81.34Lymphocyte depleted Hodgkin lymphoma, lymph nodes of axilla and upper limb

Includes

Official

No Includes notes are included in this display for C81.38. 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 C81.38. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for C81.38. Check the code and parent instructions in the Code Book.

Code Also

Official

No Code Also instructions are included in this display for C81.38. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance

Pathology confirming lymphocyte depleted Hodgkin lymphoma from at least one biopsy site

Imaging documenting involvement of at least two distinct lymph node regions

Specific identification of all involved nodal regions

Ann Arbor staging reflecting multi-site nodal involvement

MEAT Support

HCC Buddy guidance

Pathology confirming lymphocyte depleted Hodgkin lymphoma from at least one biopsy site

Imaging documenting involvement of at least two distinct lymph node regions

Specific identification of all involved nodal regions

Ann Arbor staging reflecting multi-site nodal involvement

Audit Caution

HCC Buddy guidance

Using C81.38 when only one nodal region is involved — verify that at least two distinct nodal regions are documented

Assigning multiple individual site codes instead of the single multiple sites code C81.38

Not confirming the histologic subtype from pathology before coding — lymphocyte depleted is very rare and easily confused with other subtypes

Failing to update to remission code C81.3A when treatment response is achieved

Common Mistakes

HCC Buddy guidance

C81.30-C81.36 — Single-site lymphocyte depleted Hodgkin lymphoma codes: use C81.38 only when two or more distinct regions are documented

C81.39 — Extranodal/solid organ sites: C81.38 is for multiple lymph node regions; C81.39 is for organ involvement outside the lymph node system

C81.28 — Mixed cellularity Hodgkin lymphoma, multiple sites: same site pattern but different subtype

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 C81.38 an HCC code?

Yes. C81.38 (Lymphocyte depleted Hodgkin lymphoma, lymph nodes of multiple sites) 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: C81.38 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: C81.38
Description: Lymphocyte depleted Hodgkin lymphoma, lymph nodes of multiple sites
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 C81.38 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for C81.38

For C81.38, 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

C81.38 is the ICD-10-CM diagnosis code for lymphocyte depleted hodgkin lymphoma, lymph nodes of multiple sites. This is a type of Hodgkin lymphoma (a cancer of the lymph system) where there are very few lymphocytes (a type of white blood cell) present, and the cancer is found in lymph nodes in multiple locations throughout the body. This is a rare and aggressive form of Hodgkin lymphoma. C81.38 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, C81.38 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 C81.38; 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.

The sixth character '3' indicates lymphocyte-depleted type; ensure you have confirmed this histological subtype from the pathology report before coding. For C81.38, 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 C81.38 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•The sixth character '3' indicates lymphocyte-depleted type; ensure you have confirmed this histological subtype from the pathology report before coding
•The seventh character '8' specifies multiple lymph node sites; verify documentation clearly states involvement of multiple nodal regions (not just one area) to justify this code selection

Clinical Significance

Lymphocyte depleted Hodgkin lymphoma affecting multiple lymph node sites represents widespread dissemination of the most aggressive classical Hodgkin subtype. Multi-site involvement combined with the poor prognostic histology typically requires the most intensive available treatment regimens, often including escalated BEACOPP or consideration for clinical trial enrollment. Resource utilization is extremely high.

Documentation Requirements

✓Pathology confirming lymphocyte depleted Hodgkin lymphoma from at least one biopsy site
✓Imaging documenting involvement of at least two distinct lymph node regions
✓Specific identification of all involved nodal regions
✓Ann Arbor staging reflecting multi-site nodal involvement
✓Active treatment documentation or surveillance plan

Commonly Confused Codes

•C81.30-C81.36: Single-site lymphocyte depleted Hodgkin lymphoma codes: use C81.38 only when two or more distinct regions are documented
•C81.39: Extranodal/solid organ sites: C81.38 is for multiple lymph node regions; C81.39 is for organ involvement outside the lymph node system
•C81.28: Mixed cellularity Hodgkin lymphoma, multiple sites: same site pattern but different subtype