C84.77
BillableAnaplastic large cell lymphoma, ALK-negative, spleen
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
A type of aggressive lymphoma (cancer of immune cells) without a specific genetic marker (ALK-negative) that is located in the spleen.
Coding Tips
- •Confirm splenic involvement through imaging (ultrasound, CT, or PET scan) or pathology findings if splenectomy was performed
- •Document whether splenic involvement is isolated or occurs with other nodal sites
Clinical Significance
Anaplastic large cell lymphoma, ALK-negative, involving the spleen signifies splenic infiltration by aggressive T-cell lymphoma without the favorable ALK marker. This must be carefully distinguished from hepatosplenic T-cell lymphoma (C86.1), which is a separate entity with even worse prognosis. Splenic involvement can cause cytopenias, splenomegaly, and constitutional symptoms.
Documentation Requirements
- ✓Pathology confirming ALCL morphology with CD30 positivity and ALK-negative status
- ✓Imaging documenting splenic involvement (splenomegaly, focal lesions)
- ✓Exclusion of hepatosplenic T-cell lymphoma through appropriate immunophenotyping
- ✓Splenectomy pathology if performed
- ✓Clinical staging and disease extent
Commonly Confused Codes
C86.1 — Hepatosplenic T-cell lymphoma: Distinct entity with gamma-delta T-cell phenotype and sinusoidal infiltration; much worse prognosisC84.67 — ALCL ALK-positive, spleen: Different ALK statusC84.47 — PTCL-NOS, spleen: Different lymphoma subtypeC84.73 — ALCL ALK-negative, intra-abdominal: Spleen has its own code; not an abdominal lymph node
Code Hierarchy
└C84Mature T/NK-cell lymphomas└C84.7Anaplastic large cell lymphoma, ALK-negative└C84.77Anaplastic large cell lymphoma, ALK-negative, spleen
└C84.77Anaplastic large cell lymphoma, ALK-negative, spleen