C84.67
BillableAnaplastic large cell lymphoma, ALK-positive, spleen
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 that starts in immune cells and involves the spleen. It is characterized by the presence of a specific genetic abnormality (ALK-positive) that helps doctors identify and treat this particular form of lymphoma.
Coding Tips
- •Verify documentation confirms both the ALK-positive status and spleen involvement before assigning this code, as these are essential specificity requirements
- •Ensure the code is paired with appropriate staging information (typically codes from C84.6- series) and any relevant treatment codes to provide complete clinical picture
Clinical Significance
Anaplastic large cell lymphoma, ALK-positive, involving the spleen indicates splenic infiltration by this ALK-driven T-cell malignancy. Splenic involvement may present with splenomegaly, left upper quadrant pain, or cytopenias. Distinguishing this from hepatosplenic T-cell lymphoma is essential because the two entities have vastly different prognoses and treatment approaches.
Documentation Requirements
- ✓Pathology confirming ALCL with ALK positivity (not hepatosplenic T-cell lymphoma)
- ✓Imaging documenting splenic involvement (CT, ultrasound, or PET/CT)
- ✓CD30 positivity on immunohistochemistry
- ✓Splenectomy pathology if applicable
- ✓Clinical staging and disease extent
Commonly Confused Codes
C86.1 — Hepatosplenic T-cell lymphoma: A distinct and more aggressive entity with gamma-delta T-cell phenotype and sinusoidal infiltration; must be excludedC84.77 — ALCL ALK-negative, spleen: Different ALK status; confirm molecular testingC84.47 — PTCL-NOS, spleen: Different subtype; ALCL has distinct morphologic featuresC84.63 — ALCL ALK-positive, intra-abdominal: Spleen has its own designated code; do not code as abdominal
Code Hierarchy
└C84Mature T/NK-cell lymphomas└C84.6Anaplastic large cell lymphoma, ALK-positive└C84.67Anaplastic large cell lymphoma, ALK-positive, spleen
└C84.67Anaplastic large cell lymphoma, ALK-positive, spleen