C84.62
BillableAnaplastic large cell lymphoma, ALK-positive, intrathoracic lymph nodes
HCC Category Mapping
V28HCC 20 — Lung and Other Severe Cancers
0.000V24HCC 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
An aggressive type of lymphoma with large abnormal cells that is positive for ALK protein, affecting lymph nodes in the chest.
Coding Tips
- •Confirm ALK-positive status is documented; ALK-negative anaplastic large cell lymphoma uses different codes
- •Verify intrathoracic lymph nodes are the primary site of involvement
Clinical Significance
Anaplastic large cell lymphoma, ALK-positive, involving intrathoracic lymph nodes indicates mediastinal or hilar lymph node involvement by this aggressive T-cell lymphoma. Intrathoracic disease can cause superior vena cava syndrome, airway compression, or pleural effusions. ALK-positive status suggests better response to chemotherapy and potential benefit from ALK inhibitors.
Documentation Requirements
- ✓Pathology confirming ALCL with ALK positivity and CD30 expression
- ✓Chest imaging (CT or PET/CT) documenting mediastinal, hilar, or other intrathoracic lymph node involvement
- ✓Clinical staging with notation of bulky disease if present
- ✓Documentation of any compressive symptoms from intrathoracic disease
- ✓T-cell immunophenotype confirmed
Commonly Confused Codes
C84.72 — ALCL, ALK-negative, intrathoracic: ALK-negative has worse prognosis; confirm molecular testingC84.42 — PTCL-NOS, intrathoracic: PTCL-NOS lacks the hallmark cells and CD30 positivity of ALCLC85.22 — Mediastinal (thymic) large B-cell lymphoma, intrathoracic: B-cell mediastinal lymphoma can mimic ALCL clinically; differentiate by immunophenotypeC84.92 — Mature T/NK-cell lymphoma, unspecified, intrathoracic: Use specific ALCL code when subtype is confirmed
Code Hierarchy
└C84Mature T/NK-cell lymphomas└C84.6Anaplastic large cell lymphoma, ALK-positive└C84.62Anaplastic large cell lymphoma, ALK-positive, intrathoracic lymph nodes
└C84.62Anaplastic large cell lymphoma, ALK-positive, intrathoracic lymph nodes