C82.48

Billable

Follicular lymphoma grade IIIb, lymph nodes of multiple 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

A type of cancer of the lymph system (follicular lymphoma) in an advanced stage, affecting lymph nodes in multiple different areas of the body.

Coding Tips

•Multiple site involvement indicates stage III or IV disease; document all affected regions for staging accuracy
•Ensure grade IIIb is clearly documented when coding multiple site involvement

Clinical Significance

Follicular lymphoma grade IIIb involving lymph nodes at multiple sites indicates widespread aggressive disease, typically stage III or IV. The multi-site involvement signals systemic disease that requires chemoimmunotherapy rather than localized treatment. Grade IIIb behaves more aggressively than lower-grade follicular lymphomas and multi-site disease compounds the prognostic concern, making accurate staging and coding essential for treatment planning.

Documentation Requirements

✓Pathology report confirming grade IIIb histology
✓Imaging documenting involvement of two or more distinct lymph node regions
✓Specific identification of all involved lymph node regions (cervical, axillary, mediastinal, etc.)
✓Ann Arbor staging with Lugano modification if applicable
✓FLIPI (Follicular Lymphoma International Prognostic Index) score if documented
✓Treatment plan and response assessment criteria

Commonly Confused Codes

C82.49 — Follicular lymphoma grade IIIb, extranodal and solid organ sites: Use C82.48 for nodal disease at multiple sites; use C82.49 only when extranodal organs (liver, bone marrow, GI) are involved C82.38 — Follicular lymphoma grade IIIa, lymph nodes of multiple sites: Ensure pathology specifies IIIb (centroblasts only) vs. IIIa (mixed centrocytes and centroblasts)C83.38 — Diffuse large B-cell lymphoma, lymph nodes of multiple sites: Grade IIIb can mimic diffuse large B-cell lymphoma; pathology must confirm follicular architecture

Code Hierarchy

└C82Follicular lymphoma └C82.4Follicular lymphoma grade IIIb └C82.48Follicular lymphoma grade IIIb, lymph nodes of multiple sites

└C82.48Follicular lymphoma grade IIIb, lymph nodes of multiple sites