C84.68
BillableAnaplastic large cell lymphoma, ALK-positive, lymph nodes of multiple sites
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 multiple locations throughout the body.
Coding Tips
- •Confirm ALK-positive status and multiple lymph node site involvement
- •Document all affected lymph node regions for complete clinical picture
Clinical Significance
Anaplastic large cell lymphoma, ALK-positive, involving lymph nodes of multiple sites indicates widespread nodal disease. Multi-site involvement typically corresponds to advanced-stage disease (Ann Arbor stage III-IV) but the ALK-positive status still confers a relatively favorable prognosis. This code captures the extent of disease distribution important for treatment planning.
Documentation Requirements
- ✓Pathology confirming ALCL ALK-positive with CD30 expression
- ✓Imaging documenting lymph node involvement in two or more distinct anatomical regions
- ✓All involved nodal regions identified and documented
- ✓Ann Arbor clinical staging
- ✓T-cell lineage confirmed
Commonly Confused Codes
C84.61-C84.67 — Site-specific ALCL ALK-positive codes: Use these only when one region is involved; C84.68 requires documented involvement of two or more regionsC84.60 — ALCL ALK-positive, unspecified site: Unspecified means site is unknown; C84.68 means multiple known sitesC84.78 — ALCL ALK-negative, multiple sites: Different ALK status with prognostic significanceC84.69 — ALCL ALK-positive, extranodal: C84.68 is for multiple lymph node sites; C84.69 is for organ/extranodal involvement
Code Hierarchy
└C84Mature T/NK-cell lymphomas└C84.6Anaplastic large cell lymphoma, ALK-positive└C84.68Anaplastic large cell lymphoma, ALK-positive, lymph nodes of multiple sites
└C84.68Anaplastic large cell lymphoma, ALK-positive, lymph nodes of multiple sites