C81.49

Billable

Lymphocyte-rich Hodgkin lymphoma, extranodal and solid organ sites

HCC Category Mapping

V28HCC 21 — Breast, Prostate, Colorectal and Other Cancers and Tumors

0.545

V24HCC 10 — Lymphoma and Other Cancers

0.675

ESRDHCC 10 — Lymphoma and Other Cancers

0.000

RxHCCHCC 21 — Hodgkin Lymphoma and Other Cancers

0.000

What This Code Means

This is a type of Hodgkin lymphoma (a cancer of the lymph system) where lymphocytes are the predominant cancer cells, and the cancer is found in organs or tissues outside the lymph nodes. This represents an advanced stage of the disease affecting solid organs or extranodal sites.

Coding Tips

•Verify the pathology report confirms 'lymphocyte-rich' subtype and documents involvement of extranodal or solid organ sites to support this specific code selection
•This code requires documentation of the specific site(s) affected; ensure the primary site is clearly identified in the medical record before assigning this code

Clinical Significance

Lymphocyte-rich Hodgkin lymphoma with extranodal and solid organ involvement indicates stage IV disease even within this favorable-prognosis subtype. Organ involvement (liver, lung, bone, bone marrow) requires intensified treatment and closer monitoring. The lymphocyte-rich histology may still predict relatively favorable outcomes compared to other subtypes with similar staging.

Documentation Requirements

✓Pathology confirming lymphocyte-rich Hodgkin lymphoma
✓Documentation of specific extranodal organ(s) involved with imaging or biopsy confirmation
✓Bone marrow biopsy results when marrow involvement is clinically suspected
✓Stage IV Ann Arbor designation
✓Active treatment plan and encounter-specific provider assessment

Commonly Confused Codes

C81.47 — Lymphocyte-rich Hodgkin lymphoma, spleen: splenic involvement has its own code; do not use C81.49 for isolated splenic disease C81.48 — Lymphocyte-rich Hodgkin lymphoma, multiple node sites: C81.48 is for multiple lymph node regions; C81.49 is for non-nodal organ involvement C78/C79 — Secondary malignant neoplasm codes: do not use these for lymphoma organ involvement — lymphoma is coded as primary at all sites

Code Hierarchy

└C81Hodgkin lymphoma └C81.4Lymphocyte-rich Hodgkin lymphoma └C81.49Lymphocyte-rich Hodgkin lymphoma, extranodal and solid organ sites

└C81.49Lymphocyte-rich Hodgkin lymphoma, extranodal and solid organ sites