C84.78
BillableAnaplastic large cell lymphoma, ALK-negative, lymph nodes of multiple sites
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 found in lymph nodes in multiple different areas of the body.
Coding Tips
- •This code indicates involvement of lymph nodes in two or more separate anatomical regions; document all involved sites
- •Ensure that multiple distinct nodal sites are documented before assigning this code rather than a single-site code
Clinical Significance
Anaplastic large cell lymphoma, ALK-negative, involving lymph nodes of multiple sites indicates advanced-stage disease with widespread nodal distribution. Multi-site involvement is common at diagnosis in ALK-negative ALCL and typically corresponds to Ann Arbor stage III-IV. The worse prognosis of ALK-negative disease combined with advanced stage requires intensive treatment approaches.
Documentation Requirements
- ✓Pathology confirming ALCL with CD30 positivity and ALK-negative status
- ✓Imaging documenting lymph node involvement in two or more distinct anatomical regions
- ✓All involved nodal regions identified in documentation
- ✓Ann Arbor staging
- ✓T-cell lineage confirmed
Commonly Confused Codes
C84.71-C84.77 — Site-specific ALCL ALK-negative codes: Use individual site codes when only one region is involvedC84.70 — ALCL ALK-negative, unspecified: Unspecified means unknown location; C84.78 means multiple known locationsC84.68 — ALCL ALK-positive, multiple sites: Different ALK statusC84.79 — ALCL ALK-negative, extranodal: C84.78 is for multiple lymph node sites; C84.79 is for organ involvement
Code Hierarchy
└C84Mature T/NK-cell lymphomas└C84.7Anaplastic large cell lymphoma, ALK-negative└C84.78Anaplastic large cell lymphoma, ALK-negative, lymph nodes of multiple sites
└C84.78Anaplastic large cell lymphoma, ALK-negative, lymph nodes of multiple sites