C84.64
BillableAnaplastic large cell lymphoma, ALK-positive, lymph nodes of axilla and upper limb
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 armpit and upper arm area.
Coding Tips
- •Verify ALK-positive status is documented in the pathology report
- •Confirm involvement is in axillary and upper limb lymph nodes specifically
Clinical Significance
Anaplastic large cell lymphoma, ALK-positive, involving axillary and upper limb lymph nodes is commonly seen in younger patients presenting with peripheral lymphadenopathy. Axillary involvement can cause upper extremity lymphedema and must be differentiated from reactive adenopathy or breast cancer metastasis. The favorable prognosis of ALK-positive ALCL means most patients achieve durable remissions.
Documentation Requirements
- ✓Pathology confirming ALCL with ALK expression and CD30 positivity
- ✓Documentation of axillary and/or upper limb lymph node involvement on exam or imaging
- ✓T-cell immunophenotype confirmed
- ✓Clinical staging documentation
- ✓ALK testing methodology documented (immunohistochemistry or FISH)
Commonly Confused Codes
C84.74 — ALCL, ALK-negative, axilla/upper limb: Different ALK status; worse prognosisC84.44 — PTCL-NOS, axilla/upper limb: Different lymphoma subtype without ALCL morphologyC83.34 — Diffuse large B-cell lymphoma, axilla/upper limb: B-cell lineage; most common NHL presenting with axillary nodesC77.3 — Secondary malignant neoplasm of axillary lymph nodes: Metastatic disease, not primary lymphoma
Code Hierarchy
└C84Mature T/NK-cell lymphomas└C84.6Anaplastic large cell lymphoma, ALK-positive└C84.64Anaplastic large cell lymphoma, ALK-positive, lymph nodes of axilla and upper limb
└C84.64Anaplastic large cell lymphoma, ALK-positive, lymph nodes of axilla and upper limb