C84.66
BillableAnaplastic large cell lymphoma, ALK-positive, intrapelvic 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 pelvis.
Coding Tips
- •Ensure ALK-positive status is confirmed before assigning this code
- •Document that intrapelvic lymph nodes are the site of involvement
Clinical Significance
Anaplastic large cell lymphoma, ALK-positive, involving intrapelvic lymph nodes represents deep pelvic nodal disease from this ALK-driven malignancy. Intrapelvic involvement includes iliac, obturator, and presacral nodes and may cause pelvic pain, urinary symptoms, or lower extremity edema. Detection typically requires cross-sectional imaging as these nodes are not palpable on physical examination.
Documentation Requirements
- ✓Pathology confirming ALCL ALK-positive with appropriate immunophenotype
- ✓CT, MRI, or PET/CT documenting intrapelvic lymph node involvement
- ✓Specific pelvic node groups identified (iliac, obturator, etc.)
- ✓Clinical staging
- ✓Active disease status documented
Commonly Confused Codes
C84.63 — ALCL ALK-positive, intra-abdominal: Abdominal nodes are above the pelvic brimC84.65 — ALCL ALK-positive, inguinal/lower limb: Inguinal nodes are superficial groin nodes, distinct from deep pelvic nodesC84.76 — ALCL ALK-negative, intrapelvic: Different ALK status; verify molecular testingC84.46 — PTCL-NOS, intrapelvic: Different lymphoma subtype
Code Hierarchy
└C84Mature T/NK-cell lymphomas└C84.6Anaplastic large cell lymphoma, ALK-positive└C84.66Anaplastic large cell lymphoma, ALK-positive, intrapelvic lymph nodes
└C84.66Anaplastic large cell lymphoma, ALK-positive, intrapelvic lymph nodes