Skip to content
HCC Buddy home

C84.74 ICD-10-CM Code: Anaplastic large cell lymphoma, ALK-negative, lymph nodes of axilla and upper limb

C84.74 maps to CMS-HCC V28 19. A source-labeled RAF reference is available. Confirm the documented diagnosis and applicable coding requirements. MEAT criteria · RAF Calculator · HCC coding software

ICD-10-CM Code View

HCC Buddy Code Card

Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.

Code lookupC84.74

FY 2026 Apr update / Neoplasms (C00-D49) / Malignant neoplasms of lymphoid, hematopoietic and related tissue (C81-C96)

C84.74

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Anaplastic large cell lymphoma, ALK-negative, lymph nodes of axilla and upper limb

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).

Buddy the Bee presenting code insight

Buddy Insight

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.

OverviewRisk ModelsCode BookDocumentationAuditNotesEdition comparison

CMS-HCC V28

HCC 19

Coefficient HCC 19: 1.798 (Community Non-Dual Aged (CNA))

CMS-HCC V24

Historical

Historical

Not used for CY2026 payment

ACA/HHS

HCC 010

Code-level coefficient reference

ESRD/PACE

HCC 10

Code-level coefficient reference

RXHCC

HCC 21

Code-level coefficient reference

Code Book Path

Official
C84Mature T/NK-cell lymphomasC84.7Anaplastic large cell lymphoma, ALK-negativeC84.74Anaplastic large cell lymphoma, ALK-negative, lymph nodes of axilla and upper limb

Inclusion Terms

Official

No inclusion terms are included in this display for C84.74. Check the code and parent instructions in the Code Book.

Excludes 2

Official
  • Kaposi's sarcoma of lymph nodes (C46.3)Inherited from C81-C96
  • secondary and unspecified neoplasm of lymph nodes (C77.-)Inherited from C81-C96
  • secondary neoplasm of bone marrow (C79.52)Inherited from C81-C96
  • secondary neoplasm of spleen (C78.89)Inherited from C81-C96

Related Codes

Official
C84.70Anaplastic large cell lymphoma, ALK-negative, unspecified siteC84.71Anaplastic large cell lymphoma, ALK-negative, lymph nodes of head, face, and neckC84.72Anaplastic large cell lymphoma, ALK-negative, intrathoracic lymph nodesC84.73Anaplastic large cell lymphoma, ALK-negative, intra-abdominal lymph nodesC84.75Anaplastic large cell lymphoma, ALK-negative, lymph nodes of inguinal region and lower limb

Includes

Official

No Includes notes are included in this display for C84.74. Check the code and parent instructions in the Code Book.

Excludes 1

Official
  • personal history of non-Hodgkin lymphoma (Z85.72)Inherited from C84, C84.7
  • primary cutaneous CD30-positive T-cell proliferations (C86.6-)Inherited from C84, C84.7

Code First

Official

No Code First sequencing instructions are included in this display for C84.74. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for C84.74. Check the code and parent instructions in the Code Book.

Code Also

Official

No Code Also instructions are included in this display for C84.74. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance
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

MEAT Support

HCC Buddy guidance
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

Audit Caution

HCC Buddy guidance
Confusing axillary lymphoma with metastatic breast cancer — requires pathologic distinction
Not verifying ALK status through immunohistochemistry
Using general T-cell lymphoma code when specific ALCL diagnosis is available
Failing to investigate for breast implant-associated ALCL when axillary nodes are involved

Common Mistakes

HCC Buddy guidance
C84.64 — ALCL ALK-positive, axilla/upper limb: Different ALK status; verify testing
C84.44 — PTCL-NOS, axilla/upper limb: PTCL-NOS lacks ALCL morphology
C83.34 — Diffuse large B-cell lymphoma, axilla/upper limb: B-cell origin; most common large cell lymphoma in axilla
C84.A4 — Cutaneous T-cell lymphoma, axilla/upper limb: Skin-primary disease

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Is C84.74 an HCC code?

Yes. C84.74 (Anaplastic large cell lymphoma, ALK-negative, lymph nodes of axilla and upper limb) maps to HCC 19, Myelodysplastic Syndromes, Multiple Myeloma, and Other Cancers under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 1.798. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes. It is billable for payment year 2026.

Coder answer: C84.74 is billable and maps to V28 HCC 19, Myelodysplastic Syndromes, Multiple Myeloma, and Other Cancers. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code
C84.74
Description
Anaplastic large cell lymphoma, ALK-negative, lymph nodes of axilla and upper limb
HCC (V28)
HCC 19 — Myelodysplastic Syndromes, Multiple Myeloma, and Other Cancers
RAF reference coefficient
1.798
Billable
Yes
Payment year
2026

HCC Category Mapping

V28HCC 19, Myelodysplastic Syndromes, Multiple Myeloma, and Other Cancers
1.798
ESRDHCC 10, Lymphoma and Other Cancers
Not separately weighted
RxHCCHCC 21, Lymphomas and Other Hematologic Cancers
Not separately weighted

These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. Weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.

Work C84.74 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for C84.74

For C84.74, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.

  • 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

Coder workflow notes

Get the V28 mapping + MEAT cheat sheet

One printable reference: check representative V28 mappings and the documentation reminders your note needs. Free, no card.

Free PDF. No card. Unsubscribe anytime.

What This Code Means

C84.74 is the ICD-10-CM diagnosis code for anaplastic large cell lymphoma, alk-negative, lymph nodes of axilla and upper limb. 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). C84.74 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, C84.74 maps to Myelodysplastic Syndromes, Multiple Myeloma, and Other Cancers (HCC 19) with a source-labeled community, non-dual, aged reference coefficient of 1.798. No V24 mapping is shown for C84.74; use the applicable model and payment year when reviewing the V28 mapping. For CY2026 non-PACE Medicare Advantage, CMS uses 100% of the 2024 CMS-HCC model (V28). PACE uses a separate model blend. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes.

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. For C84.74, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule. 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, source-labeled coefficient references, and MEAT documentation criteria for C84.74 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

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 testing
  • •C84.44: PTCL-NOS, axilla/upper limb: PTCL-NOS lacks ALCL morphology
  • •C83.34: Diffuse large B-cell lymphoma, axilla/upper limb: B-cell origin; most common large cell lymphoma in axilla
  • •C84.A4: Cutaneous T-cell lymphoma, axilla/upper limb: Skin-primary disease

Child Codes

C84.70Anaplastic large cell lymphoma, ALK-negative, unspecified site
HCC 19
C84.71Anaplastic large cell lymphoma, ALK-negative, lymph nodes of head, face, and neck
HCC 19
C84.72Anaplastic large cell lymphoma, ALK-negative, intrathoracic lymph nodes
HCC 19
C84.73Anaplastic large cell lymphoma, ALK-negative, intra-abdominal lymph nodes
HCC 19
C84.74Anaplastic large cell lymphoma, ALK-negative, lymph nodes of axilla and upper limb
HCC 19
C84.75Anaplastic large cell lymphoma, ALK-negative, lymph nodes of inguinal region and lower limb
HCC 19
C84.76Anaplastic large cell lymphoma, ALK-negative, intrapelvic lymph nodes
HCC 19
C84.77Anaplastic large cell lymphoma, ALK-negative, spleen
HCC 19
C84.78Anaplastic large cell lymphoma, ALK-negative, lymph nodes of multiple sites
HCC 19
C84.79Anaplastic large cell lymphoma, ALK-negative, extranodal and solid organ sites
HCC 19
C84.7AAnaplastic large cell lymphoma, ALK-negative, breast
HCC 19
C84.7BAnaplastic large cell lymphoma, ALK-negative, in remission
HCC 19

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

Also searched as

  • C84 74
  • C8474

For C84.74, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.

C84.74 maps to CMS-HCC V28 category 19, Myelodysplastic Syndromes, Multiple Myeloma, and Other Cancers. See the ICD-10 to HCC mapping hub for how the V28 crosswalk works. The mapping identifies a payment HCC category for C84.74. Review its source-labeled HCC coefficient above, check the RAF Calculator with complete member context for CMS-HCC V28 PY2026, and confirm the documentation the chart needs before the code is submitted. HCC Buddy shows no RAF score unless every required source and calculation check passes.

Work C84.74 in HCC Buddy

Open C84.74 in the Code Book for the full Index-to-Tabular path, MEAT checklist, and V28 HCC mapping, or in the Encoder to code from a keyword search. Pro includes 7 days to try everything, no card required.

Open in Code BookOpen in EncoderStart Pro