C84.60
BillableAnaplastic large cell lymphoma, ALK-positive, unspecified site
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is C84.60 an HCC code?
Yes. C84.60 maps to Lung and Other Severe Cancers 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 C84.60
For C84.60 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 C84.60 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
C84.60 is the ICD-10-CM diagnosis code for anaplastic large cell lymphoma, alk-positive, unspecified site. This is a type of aggressive blood cancer where large abnormal cells grow without a specific identified location in the body. It is characterized by a positive ALK (anaplastic lymphoma kinase) protein marker, which helps doctors identify and treat this particular cancer type. C84.60 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, C84.60 maps to Lung and Other Severe Cancers (HCC 20) with a community, non-dual, aged base RAF weight of 0.000. Under the older CMS-HCC V24 model, C84.60 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 only when the site of the lymphoma is unknown or not specified; if a specific anatomical site is documented, use the appropriate site-specific code (C84.61-C84.69). Because C84.60 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 C84.60 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use this code only when the site of the lymphoma is unknown or not specified; if a specific anatomical site is documented, use the appropriate site-specific code (C84.61-C84.69)
- •Verify ALK-positive status is documented in the pathology report before coding; ALK-negative anaplastic large cell lymphoma uses a different code (C84.70)
Clinical Significance
Anaplastic large cell lymphoma, ALK-positive, unspecified site represents an aggressive T-cell lymphoma with the ALK fusion protein, which paradoxically confers a better prognosis than ALK-negative disease. ALK-positive ALCL primarily affects younger patients and has a 5-year survival rate of approximately 70-80%. The ALK status is a critical molecular distinction that guides treatment decisions including the use of targeted therapies like crizotinib.
Documentation Requirements
- ✓Pathology report with hallmark cells (kidney-shaped nuclei) characteristic of ALCL
- ✓Immunohistochemistry confirming ALK protein expression (ALK-positive)
- ✓CD30 positivity documented (defining feature of ALCL)
- ✓T-cell lineage confirmation through immunophenotyping
- ✓Clinical staging documentation
- ✓Provider should document the specific site if known to enable more specific code assignment
Commonly Confused Codes
- •C84.70 — ALCL, ALK-negative, unspecified site: ALK-negative ALCL has worse prognosis and different treatment implications; verify ALK status before assigning
- •C84.40 — PTCL-NOS, unspecified site: PTCL-NOS is a diagnosis of exclusion; ALCL has specific morphologic features (hallmark cells, CD30+) that distinguish it
- •C81.90 — Hodgkin lymphoma, unspecified, unspecified: ALCL can mimic Hodgkin lymphoma due to CD30 positivity; distinguish through additional markers (PAX5, CD15 in Hodgkin vs. T-cell markers in ALCL)
- •C84.41-C84.49 — Site-specific PTCL-NOS: Wrong lymphoma subtype; ALCL is distinct from PTCL-NOS