C84.74
BillableAnaplastic large cell lymphoma, ALK-negative, lymph nodes of axilla and upper limb
HCC Category Mapping
V28HCC 19 — Lymphoma and Other Cancers
0.105V24HCC 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 affects lymph nodes in the armpit and upper arm area. It is characterized by large abnormal cells and does not have a specific genetic marker (ALK-negative).
Coding Tips
- •Verify the ALK status is documented as negative in the pathology report before assigning this code, as ALK-positive anaplastic large cell lymphoma uses a different code
- •Confirm the specific anatomical site (axilla and upper limb lymph nodes) is documented; if lymph nodes in other locations are also involved, additional codes may be needed to capture all affected sites
Clinical Significance
Anaplastic large cell lymphoma, ALK-negative, involving axillary and upper limb lymph nodes represents aggressive T-cell lymphoma in the armpit and upper extremity nodal basins without the favorable ALK marker. Axillary lymphadenopathy requires biopsy to distinguish from metastatic breast cancer, reactive causes, or other lymphoma types. The ALK-negative status impacts treatment intensity and prognosis.
Documentation Requirements
- ✓Pathology confirming ALCL morphology with CD30 positivity and documented ALK-negative status
- ✓Physical examination or imaging documenting axillary/upper limb lymph node involvement
- ✓T-cell immunophenotype verified
- ✓ALK testing performed and negative result confirmed
- ✓Clinical staging
Commonly Confused Codes
C84.64 — ALCL ALK-positive, axilla/upper limb: Different ALK status; verify testingC84.44 — PTCL-NOS, axilla/upper limb: PTCL-NOS lacks ALCL morphologyC83.34 — Diffuse large B-cell lymphoma, axilla/upper limb: B-cell origin; most common large cell lymphoma in axillaC84.A4 — Cutaneous T-cell lymphoma, axilla/upper limb: Skin-primary disease
Code Hierarchy
└C84Mature T/NK-cell lymphomas└C84.7Anaplastic large cell lymphoma, ALK-negative└C84.74Anaplastic large cell lymphoma, ALK-negative, lymph nodes of axilla and upper limb
└C84.74Anaplastic large cell lymphoma, ALK-negative, lymph nodes of axilla and upper limb