C82.47
BillableFollicular lymphoma grade IIIb, 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
A type of cancer of the lymph system (follicular lymphoma) in an advanced stage, located in the spleen.
Coding Tips
- •Splenic involvement should be confirmed by imaging or pathology; document whether splenectomy is planned or performed
- •Grade IIIb indicates aggressive disease; note any systemic symptoms or cytopenias related to splenic involvement
Clinical Significance
Follicular lymphoma grade IIIb with splenic involvement represents an aggressive variant of follicular lymphoma with large centroblastic cells and no residual centrocytes. Splenic disease often indicates advanced staging (typically stage IV) and may present with cytopenias due to hypersplenism or marrow infiltration. This carries a significantly different prognosis than lower-grade follicular lymphomas and often requires immediate treatment rather than watchful waiting.
Documentation Requirements
- ✓Pathology report confirming grade IIIb (centroblasts only, no centrocytes)
- ✓Imaging (CT/PET) confirming splenic involvement with measurements
- ✓Ann Arbor staging designation (typically stage III or IV with splenic disease)
- ✓B-symptom documentation (fevers, night sweats, weight loss >10%)
- ✓Current treatment status and regimen (active treatment vs. observation)
- ✓Bone marrow biopsy results if performed
Commonly Confused Codes
C82.37 — Follicular lymphoma grade IIIa, spleen: Grade IIIa retains centrocytes mixed with centroblasts, while IIIb has centroblasts only; pathology report must specify the subgradeC82.57 — Diffuse follicle center lymphoma, spleen: This is a different histologic pattern (diffuse vs. follicular architecture); confirm growth pattern on biopsyC82.87 — Other types of follicular lymphoma, spleen: Use C82.47 when grade IIIb is specifically documented rather than this less-specific alternativeC83.37 — Diffuse large B-cell lymphoma, spleen: Grade IIIb follicular lymphoma closely resembles diffuse large B-cell lymphoma but retains some follicular architecture; pathology distinction is critical
Code Hierarchy
└C82Follicular lymphoma└C82.4Follicular lymphoma grade IIIb└C82.47Follicular lymphoma grade IIIb, spleen
└C82.47Follicular lymphoma grade IIIb, spleen