C84.69
BillableAnaplastic large cell lymphoma, ALK-positive, extranodal and solid organ 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, involving organs outside the lymph node system or solid organs.
Coding Tips
- •Verify ALK-positive status is documented in pathology
- •Identify and document the specific extranodal or solid organ sites affected
Clinical Significance
Anaplastic large cell lymphoma, ALK-positive, involving extranodal and solid organ sites indicates disease outside the lymph node system. Extranodal ALCL can involve skin, bone, soft tissue, lung, or liver. Skin involvement is particularly common in ALCL and may present as primary cutaneous ALCL, which has a different prognosis than systemic ALCL with secondary skin involvement.
Documentation Requirements
- ✓Pathology confirming ALCL ALK-positive in extranodal tissue
- ✓Identification of specific organ or extranodal site involved
- ✓Biopsy of the extranodal site confirming lymphoma
- ✓CD30 and ALK expression documented
- ✓Distinction between primary cutaneous ALCL and systemic ALCL with skin involvement
Commonly Confused Codes
C84.67 — ALCL ALK-positive, spleen: Spleen has its own code and should not be coded as extranodalC86.6 — Primary cutaneous CD30-positive T-cell lymphoproliferative disorders: Primary cutaneous ALCL is a distinct entity with better prognosis than systemic ALCLC84.79 — ALCL ALK-negative, extranodal: Different ALK statusC84.68 — ALCL ALK-positive, multiple lymph node sites: C84.69 is for organ involvement, not for multiple lymph node regions
Code Hierarchy
└C84Mature T/NK-cell lymphomas└C84.6Anaplastic large cell lymphoma, ALK-positive└C84.69Anaplastic large cell lymphoma, ALK-positive, extranodal and solid organ sites
└C84.69Anaplastic large cell lymphoma, ALK-positive, extranodal and solid organ sites