C84.65
BillableAnaplastic large cell lymphoma, ALK-positive, lymph nodes of inguinal region and lower 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
This is a type of aggressive blood cancer (lymphoma) that starts in immune cells and is positive for a specific protein marker called ALK. The cancer is located in the lymph nodes in the groin area and lower leg.
Coding Tips
- •Verify the ALK-positive status is documented in the pathology report before assigning this code, as ALK-negative anaplastic large cell lymphoma uses a different code
- •Confirm the specific anatomical site (inguinal region and lower limb lymph nodes) is documented; if lymph nodes in other regions are also involved, additional codes may be needed to capture all affected sites
Clinical Significance
Anaplastic large cell lymphoma, ALK-positive, involving inguinal and lower limb lymph nodes indicates disease in the groin and lower extremity nodal basins. This presentation can cause lower extremity edema and discomfort. ALK-positive ALCL in this location must be distinguished from inguinal metastases of other malignancies and from other T-cell lymphoma subtypes presenting in this region.
Documentation Requirements
- ✓Pathology confirming ALCL with hallmark cells, ALK positivity, and CD30 expression
- ✓Physical exam or imaging documenting inguinal and/or lower limb lymph node enlargement
- ✓T-cell immunophenotype verified
- ✓Clinical staging
- ✓Documentation of active disease status
Commonly Confused Codes
C84.75 — ALCL, ALK-negative, inguinal/lower limb: Different ALK status with prognostic implicationsC84.45 — PTCL-NOS, inguinal/lower limb: Different T-cell lymphoma subtypeC84.A5 — Cutaneous T-cell lymphoma, inguinal/lower limb: Skin-primary disease distinct from nodal ALCLC84.66 — ALCL ALK-positive, intrapelvic: Deep pelvic nodes are distinct from superficial inguinal nodes
Code Hierarchy
└C84Mature T/NK-cell lymphomas└C84.6Anaplastic large cell lymphoma, ALK-positive└C84.65Anaplastic large cell lymphoma, ALK-positive, lymph nodes of inguinal region and lower limb
└C84.65Anaplastic large cell lymphoma, ALK-positive, lymph nodes of inguinal region and lower limb