C84.19
BillableSézary disease, extranodal and solid organ sites
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is C84.19 an HCC code?
Yes. C84.19 maps to Metastatic Cancer and Acute Leukemia 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 C84.19
For C84.19 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 C84.19 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
C84.19 is the ICD-10-CM diagnosis code for sézary disease, extranodal and solid organ sites. Sézary disease affecting organs and tissues outside the lymph node system, such as the liver, lungs, or other solid organs. C84.19 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, C84.19 maps to Metastatic Cancer and Acute Leukemia (HCC 17) with a community, non-dual, aged base RAF weight of 0.368. Under the older CMS-HCC V24 model, C84.19 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.
Use this code when Sézary disease involves extranodal sites or solid organs rather than lymph nodes. Because C84.19 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 C84.19 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use this code when Sézary disease involves extranodal sites or solid organs rather than lymph nodes
- •Document the specific extranodal sites involved for clinical clarity
Clinical Significance
Sezary disease with extranodal and solid organ involvement represents the most advanced form of this leukemic T-cell lymphoma with spread beyond the skin, blood, and lymph nodes into visceral organs. This may include liver, lung, bone marrow, or gastrointestinal involvement and carries the worst prognosis among Sezary disease presentations, often indicating transformation or treatment-refractory disease.
Documentation Requirements
- ✓Peripheral blood demonstrating circulating Sezary cells
- ✓Documentation of specific extranodal organs involved
- ✓Imaging or biopsy confirming organ involvement
- ✓Assessment for large cell transformation
- ✓TNMB staging and intensive treatment plan