C81.72 ICD-10-CM Code: Other Hodgkin lymphoma, intrathoracic lymph nodes
C81.72 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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FY 2026 Apr update / Neoplasms (C00-D49) / Malignant neoplasms of lymphoid, hematopoietic and related tissue (C81-C96)
C81.72
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceOther Hodgkin lymphoma, intrathoracic lymph nodes
A less common type of Hodgkin lymphoma affecting lymph nodes inside the chest cavity.
Buddy Insight
Other Hodgkin lymphoma of intrathoracic lymph nodes represents an uncommon variant in a typical presentation site.
CMS-HCC V28
MappedHCC 21
Coefficient HCC 21: 0.671 (Community Non-Dual Aged (CNA))
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
MappedHCC 012
Code-level coefficient reference
ESRD/PACE
MappedHCC 10
Code-level coefficient reference
RXHCC
MappedHCC 21
Code-level coefficient reference
Code Book Path
Inclusion Terms
Official- Classical Hodgkin lymphoma NOSInherited from C81.7
- Other classical Hodgkin lymphomaInherited from C81.7
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
Includes
OfficialNo Includes notes are included in this display for C81.72. 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
OfficialNo Code First sequencing instructions are included in this display for C81.72. Check the code and parent instructions in the Code Book.
Use Additional
OfficialNo Use Additional Code instructions are included in this display for C81.72. Check the code and parent instructions in the Code Book.
Code Also
OfficialNo Code Also instructions are included in this display for C81.72. Check the code and parent instructions in the Code Book.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
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 C81.72 an HCC code?
Yes. C81.72 (Other Hodgkin lymphoma, intrathoracic 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: C81.72 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
- C81.72
- Description
- Other Hodgkin lymphoma, intrathoracic lymph nodes
- HCC (V28)
- HCC 21 — Lymphoma and Other Cancers
- RAF reference coefficient
- 0.671
- Billable
- Yes
- Payment year
- 2026
HCC Category Mapping
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 C81.72 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →
MEAT review for C81.72
For C81.72, 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
C81.72 is the ICD-10-CM diagnosis code for other hodgkin lymphoma, intrathoracic lymph nodes. A less common type of Hodgkin lymphoma affecting lymph nodes inside the chest cavity. C81.72 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, C81.72 maps to Lymphoma and Other Cancers (HCC 21) with a source-labeled community, non-dual, aged reference coefficient of 0.671. 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.
Verify intrathoracic involvement on imaging (CT or PET scan) before coding. For C81.72, 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 C81.72 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify intrathoracic involvement on imaging (CT or PET scan) before coding
- •Distinguish from mediastinal involvement; intrathoracic includes all chest lymph nodes
Clinical Significance
Other Hodgkin lymphoma of intrathoracic lymph nodes represents an uncommon variant in a typical presentation site. Mediastinal lymphadenopathy from Hodgkin lymphoma may cause compressive symptoms including cough, dyspnea, and superior vena cava syndrome. The 'other' subtype designation indicates histology that does not fit standard Hodgkin categories, warranting potential expert pathology review.
Documentation Requirements
- ✓Pathology confirming Hodgkin lymphoma classified as 'other' subtype
- ✓Chest imaging documenting intrathoracic lymph node involvement
- ✓Assessment for bulky disease and compressive complications
- ✓Complete staging documentation
- ✓Treatment plan addressing the specific variant
Commonly Confused Codes
- •C81.12: Nodular sclerosis Hodgkin lymphoma, intrathoracic: the most common subtype in the mediastinum; careful pathology review needed
- •C81.92: Hodgkin lymphoma, unspecified type, intrathoracic: use C81.72 when pathology classifies the variant; use C81.92 when the type cannot be determined
- •C85.22: Mediastinal large B-cell lymphoma: a non-Hodgkin entity distinct from Hodgkin lymphoma