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C84.66

Billable

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

Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)

Is C84.66 an HCC code?

Yes. C84.66 maps to Lung and Other Severe Cancers under the CMS-HCC V28 risk adjustment model (and Lymphoma and Other Cancers under V24).

HCC Category Mapping

V28HCC 20Lung and Other Severe Cancers
0.000
V24HCC 10Lymphoma and Other Cancers
0.675
ESRDHCC 10Lymphoma and Other Cancers
0.000
RxHCCHCC 21Hodgkin Lymphoma and Other Cancers
0.000

RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. 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.

MEAT Criteria for C84.66

For C84.66 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 C84.66 during that encounter — not just copy-forwarded from a problem list.

What This Code Means

C84.66 is the ICD-10-CM diagnosis code for anaplastic large cell lymphoma, alk-positive, intrapelvic lymph nodes. An aggressive type of lymphoma with large abnormal cells that is positive for ALK protein, affecting lymph nodes in the pelvis. C84.66 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, C84.66 maps to Lung and Other Severe Cancers (HCC 20) with a community, non-dual, aged base RAF weight of 0.000. Under the older CMS-HCC V24 model, C84.66 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.

Ensure ALK-positive status is confirmed before assigning this code. Because C84.66 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 C84.66 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

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

Code Hierarchy

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