C81.38
BillableLymphocyte depleted Hodgkin lymphoma, lymph nodes of multiple sites
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is C81.38 an HCC code?
Yes. C81.38 maps to Breast, Prostate, Colorectal and Other Cancers and Tumors under the CMS-HCC V28 risk adjustment model (and Lymphoma and Other Cancers under V24).
HCC Category Mapping
RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.
MEAT Criteria for C81.38
For C81.38 to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically — it has to be re-documented and supported each calendar year.
- 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
Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed C81.38 during that encounter — not just copy-forwarded from a problem list.
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 Breast, Prostate, Colorectal and Other Cancers and Tumors (HCC 21) with a community, non-dual, aged base RAF weight of 0.545. Under the older CMS-HCC V24 model, C81.38 maps to Lymphoma and Other Cancers (HCC 10) with a community, non-dual, aged base RAF weight of 0.675. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition.
The sixth character '3' indicates lymphocyte-depleted type; ensure you have confirmed this histological subtype from the pathology report before coding. Because C81.38 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. 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, RAF weights, 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