What is ICD-10 code C85.1A?

C85.1A is the ICD-10-CM diagnosis code for Unspecified B-cell lymphoma, in remission. A type of B-cell cancer that is currently in remission, meaning the cancer is not actively growing or has responded well to treatment. It belongs to the ICD-10-CM chapter for neoplasms (c00-d49). C85.1A is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. C85.1A is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. C85.1A is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. C85.1A is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

What is the V28 vs V24 difference for C85.1A?

CMS phased in the V28 risk adjustment model over payment years 2024 (33%), 2025 (67%), and 2026 (100%), replacing V24. V28 consolidates HCC categories, removes some lower-acuity conditions, and recalibrates RAF weights across the entire model. For C85.1A, V28 maps to Lymphoma and Other Cancers at RAF 0.671 while V24 mapped to Lymphoma and Other Cancers at RAF 0.675. Both models can still appear in legacy data and in payer-specific lookback periods.

What should coders know when reporting C85.1A?

Use this code only when documentation explicitly states the patient is in remission or has achieved complete or partial response Do not use this code if there is any evidence of active disease or recurrence Because C85.1A maps to a payment HCC, the documentation must also satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's risk adjustment score.

2026 ICD-10-CM C85.1A: Unspecified B-cell lymphoma

ICD-10-CM Code View

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Code lookupC85.1AEffective periodFY2026 Apr Update (Apr 1-Sep 30)

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

C85.1A

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

Unspecified B-cell lymphoma, in remission

A type of B-cell cancer that is currently in remission, meaning the cancer is not actively growing or has responded well to treatment.

Buddy Insight

Unspecified B-cell lymphoma in remission indicates a patient with a B-cell neoplasm that has responded to treatment but whose specific subtype was never fully characterized.

CMS-HCC V28

Mapped

HCC 21

Lymphoma and Other Cancers

RAF 0.671

CMS-HCC V24

Mapped

HCC 10

Lymphoma and Other Cancers

RAF 0.675

ACA/HHS

Mapped

HCC 10

HHS-HCC 10

Varies by metal level

ESRD/PACE

Mapped

HCC 10

Lymphoma and Other Cancers

RAF 0.111

RXHCC

Mapped

HCC 21

Hodgkin Lymphoma and Other Ca...

RAF 0.410

Code Book Path

Official

C85Other specified and unspecified types of non-Hodgkin lymphoma

C85.1Unspecified B-cell lymphoma

C85.1AUnspecified B-cell lymphoma, in remission

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for C85.1A in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for C85.1A in this effective period.

Related Child Codes

Official

C85.10Unspecified B-cell lymphoma, unspecified site

C85.11Unspecified B-cell lymphoma, lymph nodes of head, face, and neck

C85.12Unspecified B-cell lymphoma, intrathoracic lymph nodes

C85.13Unspecified B-cell lymphoma, intra-abdominal lymph nodes

C85.14Unspecified B-cell lymphoma, lymph nodes of axilla and upper limb

Includes

Official

ICD-10-CM does not list Includes notes for C85.1A in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for C85.1A in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for C85.1A in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for C85.1A in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for C85.1A in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Explicit provider documentation of 'remission' or 'complete response' — not just 'off treatment'

Original pathology report showing B-cell lineage (CD20+, CD19+, or other B-cell markers)

Date remission was achieved and method of assessment (PET/CT, bone marrow biopsy)

Surveillance plan including follow-up imaging and laboratory schedule

MEAT Support

HCC Buddy guidance

Explicit provider documentation of 'remission' or 'complete response' — not just 'off treatment'

Original pathology report showing B-cell lineage (CD20+, CD19+, or other B-cell markers)

Date remission was achieved and method of assessment (PET/CT, bone marrow biopsy)

Surveillance plan including follow-up imaging and laboratory schedule

Audit Caution

HCC Buddy guidance

Using remission code when documentation states 'partial response' or 'stable disease' — these are not synonymous with remission

Not querying pathology for specific B-cell subtype before defaulting to unspecified

Confusing 'no evidence of disease' at a single time point with formally documented remission

Failing to differentiate between remission and personal history when no active monitoring is planned

Common Mistakes

HCC Buddy guidance

Z85.79 (Personal history of other malignant neoplasms of lymphoid tissue) — Use history code when cancer is fully eradicated; use C85.1A when patient is in remission but still being monitored

C85.10 (Unspecified B-cell lymphoma, unspecified site) — C85.1A is specifically for remission status; C85.10 is for active disease with unknown site

C83.30-C83.3A (Diffuse large B-cell lymphoma) — If the B-cell subtype is known as DLBCL, use the specific C83.3 code series

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 C85.1A an HCC code?

Yes. C85.1A (Unspecified B-cell lymphoma, in remission) maps to Lymphoma and Other Cancers under the CMS-HCC V28 risk adjustment model (and Lymphoma and Other Cancers under V24), with a community non-dual aged RAF of 0.671. It is billable for payment year 2026.

Coder answer: C85.1A is billable and maps to V28 HCC 21, Lymphoma and Other Cancers. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code: C85.1A
Description: Unspecified B-cell lymphoma, in remission
HCC (V28): HCC 21 — Lymphoma and Other Cancers
RAF: 0.671
Billable: Yes
Payment year: 2026

HCC Category Mapping

V28HCC 21, Lymphoma and Other Cancers

0.671

V24HCC 10, Lymphoma and Other Cancers

0.675

ESRDHCC 10, Lymphoma and Other Cancers

0.111

RxHCCHCC 21, Hodgkin Lymphoma and Other Cancers

0.410

Each model's RAF is its CMS base weight for that model's standard population, so 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 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.

Work C85.1A in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for C85.1A

For C85.1A 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 C85.1A during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

C85.1A is the ICD-10-CM diagnosis code for unspecified b-cell lymphoma, in remission. A type of B-cell cancer that is currently in remission, meaning the cancer is not actively growing or has responded well to treatment. C85.1A 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, C85.1A maps to Lymphoma and Other Cancers (HCC 21) with a community, non-dual, aged base RAF weight of 0.671. Under the older V24 model, C85.1A mapped to the same category but with a base RAF weight of 0.675, V28 recalibrated weights across the entire model. 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.

Use this code only when documentation explicitly states the patient is in remission or has achieved complete or partial response. Because C85.1A 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 C85.1A sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Use this code only when documentation explicitly states the patient is in remission or has achieved complete or partial response
•Do not use this code if there is any evidence of active disease or recurrence

Clinical Significance

Unspecified B-cell lymphoma in remission indicates a patient with a B-cell neoplasm that has responded to treatment but whose specific subtype was never fully characterized. Even in remission, these patients require ongoing surveillance with periodic imaging and laboratory monitoring. The unspecified nature of the B-cell subtype should prompt a query to determine if more specific classification is possible.

Documentation Requirements

✓Explicit provider documentation of 'remission' or 'complete response' — not just 'off treatment'
✓Original pathology report showing B-cell lineage (CD20+, CD19+, or other B-cell markers)
✓Date remission was achieved and method of assessment (PET/CT, bone marrow biopsy)
✓Surveillance plan including follow-up imaging and laboratory schedule

Commonly Confused Codes

•Z85.79 (Personal history of other malignant neoplasms of lymphoid tissue): Use history code when cancer is fully eradicated; use C85.1A when patient is in remission but still being monitored
•C85.10 (Unspecified B-cell lymphoma, unspecified site): C85.1A is specifically for remission status; C85.10 is for active disease with unknown site
•C83.30-C83.3A (Diffuse large B-cell lymphoma): If the B-cell subtype is known as DLBCL, use the specific C83.3 code series