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C84.62 ICD-10-CM Code: Anaplastic large cell lymphoma, ALK-positive, intrathoracic lymph nodes

C84.62 maps to CMS-HCC V28 20 (RAF 1.136). Documentation must support MEAT. MEAT criteria · RAF calculator · HCC coding software

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FY 2026 Apr update / Neoplasms (C00-D49) / Malignant neoplasms of lymphoid, hematopoietic and related tissue (C81-C96)

C84.62

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Anaplastic large cell lymphoma, ALK-positive, intrathoracic lymph nodes

An aggressive type of lymphoma with large abnormal cells that is positive for ALK protein, affecting lymph nodes in the chest.

Buddy the Bee presenting code insight

Buddy Insight

Anaplastic large cell lymphoma, ALK-positive, involving intrathoracic lymph nodes indicates mediastinal or hilar lymph node involvement by this aggressive T-cell lymphoma.

CMS-HCC V28

HCC 20

RAF 1.136

CMS-HCC V24

HCC 10

RAF 0.675

ACA/HHS

HCC 10

Varies by metal level

ESRD/PACE

HCC 10

RAF 0.111

RXHCC

HCC 21

RAF 0.410

Code Book Path

Official
C84Mature T/NK-cell lymphomas
C84.6Anaplastic large cell lymphoma, ALK-positive
C84.62Anaplastic large cell lymphoma, ALK-positive, intrathoracic lymph nodes

Inclusion Terms

Official
  • Anaplastic large cell lymphoma, CD30-positive

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for C84.62 in this effective period.

Related Child Codes

Official
C84.60Anaplastic large cell lymphoma, ALK-positive, unspecified site
C84.61Anaplastic large cell lymphoma, ALK-positive, lymph nodes of head, face, and neck
C84.63Anaplastic large cell lymphoma, ALK-positive, intra-abdominal lymph nodes
C84.64Anaplastic large cell lymphoma, ALK-positive, lymph nodes of axilla and upper limb
C84.65Anaplastic large cell lymphoma, ALK-positive, lymph nodes of inguinal region and lower limb

Includes

Official

ICD-10-CM does not list Includes notes for C84.62 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for C84.62 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for C84.62 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for C84.62 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for C84.62 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
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

MEAT Support

HCC Buddy guidance
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

Audit Caution

HCC Buddy guidance
Coding mediastinal large B-cell lymphoma as ALCL when both can present with mediastinal masses
Using unspecified T-cell lymphoma code when ALCL ALK+ is confirmed on pathology
Not verifying ALK status through proper immunohistochemistry or FISH testing
Failing to update site code if disease extends beyond intrathoracic region to multiple sites

Common Mistakes

HCC Buddy guidance
C84.72 — ALCL, ALK-negative, intrathoracic: ALK-negative has worse prognosis; confirm molecular testing
C84.42 — PTCL-NOS, intrathoracic: PTCL-NOS lacks the hallmark cells and CD30 positivity of ALCL
C85.22 — Mediastinal (thymic) large B-cell lymphoma, intrathoracic: B-cell mediastinal lymphoma can mimic ALCL clinically; differentiate by immunophenotype
C84.92 — Mature T/NK-cell lymphoma, unspecified, intrathoracic: Use specific ALCL code when subtype is confirmed

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Is C84.62 an HCC code?

Yes. C84.62 (Anaplastic large cell lymphoma, ALK-positive, intrathoracic lymph nodes) maps to Lung and Other Severe Cancers under the CMS-HCC V28 risk adjustment model (and Lymphoma and Other Cancers under V24), with a community non-dual aged RAF of 1.136. It is billable for payment year 2026.

Coder answer: C84.62 is billable and maps to V28 HCC 20, Lung and Other Severe Cancers. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code
C84.62
Description
Anaplastic large cell lymphoma, ALK-positive, intrathoracic lymph nodes
HCC (V28)
HCC 20 — Lung and Other Severe Cancers
RAF
1.136
Billable
Yes
Payment year
2026

HCC Category Mapping

V28HCC 20, Lung and Other Severe Cancers
1.136
V24HCC 10, Lymphoma and Other Cancers
0.675
ESRDHCC 10, Lymphoma and Other Cancers
0.111
RxHCCHCC 21, Hodgkin Lymphoma and Other Cancers
0.410

Each model's RAF is its CMS base weight for that model's standard population, so weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. 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.

Work C84.62 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for C84.62

For C84.62 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 C84.62 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

C84.62 is the ICD-10-CM diagnosis code for anaplastic large cell lymphoma, alk-positive, intrathoracic lymph nodes. An aggressive type of lymphoma with large abnormal cells that is positive for ALK protein, affecting lymph nodes in the chest. C84.62 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, C84.62 maps to Lung and Other Severe Cancers (HCC 20) with a community, non-dual, aged base RAF weight of 1.136. Under the older CMS-HCC V24 model, C84.62 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.

Confirm ALK-positive status is documented; ALK-negative anaplastic large cell lymphoma uses different codes. Because C84.62 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 C84.62 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

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 testing
  • C84.42: PTCL-NOS, intrathoracic: PTCL-NOS lacks the hallmark cells and CD30 positivity of ALCL
  • C85.22: Mediastinal (thymic) large B-cell lymphoma, intrathoracic: B-cell mediastinal lymphoma can mimic ALCL clinically; differentiate by immunophenotype
  • C84.92: Mature T/NK-cell lymphoma, unspecified, intrathoracic: Use specific ALCL code when subtype is confirmed

Child Codes

Code Hierarchy

Because C84.62 maps to a payment HCC, the documentation must also satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's risk adjustment score.

C84.62 maps to CMS-HCC V28 category 20, Lung and Other Severe Cancers. See the ICD-10 to HCC mapping hub for how the V28 crosswalk works. Because C84.62 carries a payment HCC, you can see what it adds to a RAF score and check the documentation the chart needs before it is submitted.

Work C84.62 in HCC Buddy

Open C84.62 in the Code Book for the full Index-to-Tabular path, MEAT checklist, and V28 HCC mapping, or in the Encoder to code from a keyword search. Pro includes 7 days to try everything, no card required.