C84.97
BillableMature T/NK-cell lymphomas, unspecified, spleen
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is C84.97 an HCC code?
Yes. C84.97 maps to Lung and Other Severe Cancers under the CMS-HCC V28 risk adjustment model (and Lymphoma and Other Cancers under V24).
HCC Category Mapping
RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.
MEAT Criteria for C84.97
For C84.97 to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically — it has to be re-documented and supported each calendar year.
- 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
Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed C84.97 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
C84.97 is the ICD-10-CM diagnosis code for mature t/nk-cell lymphomas, unspecified, spleen. A mature T-cell or natural killer cell lymphoma affecting the spleen, an organ that filters blood and stores immune cells. C84.97 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, C84.97 maps to Lung and Other Severe Cancers (HCC 20) with a community, non-dual, aged base RAF weight of 0.000. Under the older CMS-HCC V24 model, C84.97 maps to Lymphoma and Other Cancers (HCC 10) with a community, non-dual, aged base RAF weight of 0.675. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition.
Confirm splenic involvement through imaging, physical examination, or pathology findings. Because C84.97 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. 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, RAF weights, and MEAT documentation criteria for C84.97 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Confirm splenic involvement through imaging, physical examination, or pathology findings
- •Note if splenomegaly (enlarged spleen) is present and documented
Clinical Significance
Mature T/NK-cell lymphomas, unspecified, involving the spleen captures unclassified T/NK-cell lymphoma with splenic involvement. The spleen is a common site for lymphoma involvement and can present with splenomegaly, cytopenias, or incidental imaging findings. Further subtyping is important because specific entities like hepatosplenic T-cell lymphoma have distinct prognoses and treatments.
Documentation Requirements
- ✓Pathology confirming mature T-cell or NK-cell lymphoma in splenic tissue or confirmed by imaging
- ✓Imaging documenting splenic involvement
- ✓Immunophenotyping distinguishing from hepatosplenic T-cell lymphoma
- ✓Documentation of why further subtype classification was not achieved
- ✓Clinical staging
Commonly Confused Codes
- •C86.1 — Hepatosplenic T-cell lymphoma: A specific entity with gamma-delta phenotype and sinusoidal infiltration; must be excluded
- •C84.47/C84.67/C84.77 — Splenic codes for specific T-cell lymphoma subtypes: Use when subtype is confirmed
- •C84.93 — Mature T/NK-cell lymphoma, intra-abdominal: Spleen has its own code; not an abdominal node
- •D73.89 — Other diseases of spleen: Not a neoplastic code