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C85.8A ICD-10-CM Code: Other specified types of non-Hodgkin lymphoma, in remission

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

C85.8A

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

Other specified types of non-Hodgkin lymphoma, in remission

A specific type of non-Hodgkin lymphoma (cancer of the lymph system) that is not further classified, and the patient is currently in remission with no active disease.

Buddy the Bee presenting code insight

Buddy Insight

Other specified non-Hodgkin lymphoma in remission captures patients with named NHL subtypes not classified elsewhere who have achieved disease control.

CMS-HCC V28

HCC 21

RAF 0.671

CMS-HCC V24

HCC 10

RAF 0.675

ACA/HHS

HCC 10

Varies by metal level

ESRD/PACE

HCC 10

RAF 0.111

RXHCC

HCC 21

RAF 0.410

Code Book Path

Official
C85Other specified and unspecified types of non-Hodgkin lymphoma
C85.8Other specified types of non-Hodgkin lymphoma
C85.8AOther specified types of non-Hodgkin lymphoma, in remission

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for C85.8A in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for C85.8A in this effective period.

Related Child Codes

Official
C85.80Other specified types of non-Hodgkin lymphoma, unspecified site
C85.81Other specified types of non-Hodgkin lymphoma, lymph nodes of head, face, and neck
C85.82Other specified types of non-Hodgkin lymphoma, intrathoracic lymph nodes
C85.83Other specified types of non-Hodgkin lymphoma, intra-abdominal lymph nodes
C85.84Other specified types of non-Hodgkin lymphoma, lymph nodes of axilla and upper limb

Includes

Official

ICD-10-CM does not list Includes notes for C85.8A in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for C85.8A in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for C85.8A in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for C85.8A in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for C85.8A in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
Explicit documentation of remission or complete response with date of assessment
Original pathology specifying the non-Hodgkin lymphoma subtype that does not have its own ICD-10 code
Method of remission confirmation (PET/CT, biopsy, bone marrow evaluation)
Planned surveillance frequency and monitoring modalities

MEAT Support

HCC Buddy guidance
Explicit documentation of remission or complete response with date of assessment
Original pathology specifying the non-Hodgkin lymphoma subtype that does not have its own ICD-10 code
Method of remission confirmation (PET/CT, biopsy, bone marrow evaluation)
Planned surveillance frequency and monitoring modalities

Audit Caution

HCC Buddy guidance
Assigning remission when provider documents 'stable disease' or 'partial response'
Not verifying that the NHL subtype truly lacks a more specific ICD-10 code before using C85.8
Confusing clinical remission with cure — remission still requires active monitoring
Using this code for NHL subtypes that have their own specific codes (DLBCL, follicular, mantle cell, etc.)

Common Mistakes

HCC Buddy guidance
C85.1A (Unspecified B-cell lymphoma, in remission) — C85.8A is for specified subtypes without their own code; C85.1A is for B-cell lymphoma where the subtype is unknown
C85.9x (Non-Hodgkin lymphoma, unspecified) — C85.8 indicates a specified type; C85.9 is fully unspecified
Z85.79 (Personal history of lymphoid neoplasms) — Use for fully resolved disease; C85.8A indicates active remission monitoring

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 C85.8A an HCC code?

Yes. C85.8A (Other specified types of non-Hodgkin 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: C85.8A 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
C85.8A
Description
Other specified types of non-Hodgkin 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 C85.8A in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for C85.8A

For C85.8A 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 C85.8A during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

C85.8A is the ICD-10-CM diagnosis code for other specified types of non-hodgkin lymphoma, in remission. A specific type of non-Hodgkin lymphoma (cancer of the lymph system) that is not further classified, and the patient is currently in remission with no active disease. C85.8A 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, C85.8A 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, C85.8A 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.

The 'A' suffix indicates remission status; ensure documentation supports that the patient is in remission before assigning this code. Because C85.8A 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 C85.8A sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • The 'A' suffix indicates remission status; ensure documentation supports that the patient is in remission before assigning this code
  • Use this code only when the specific type of NHL is identified but doesn't fit other C85.8 categories

Clinical Significance

Other specified non-Hodgkin lymphoma in remission captures patients with named NHL subtypes not classified elsewhere who have achieved disease control. This may include rare entities like intravascular large B-cell lymphoma, plasmablastic lymphoma, or primary effusion lymphoma that have responded to treatment. Ongoing surveillance is essential as many of these rare subtypes carry high relapse rates.

Documentation Requirements

  • Explicit documentation of remission or complete response with date of assessment
  • Original pathology specifying the non-Hodgkin lymphoma subtype that does not have its own ICD-10 code
  • Method of remission confirmation (PET/CT, biopsy, bone marrow evaluation)
  • Planned surveillance frequency and monitoring modalities

Commonly Confused Codes

  • C85.1A (Unspecified B-cell lymphoma, in remission): C85.8A is for specified subtypes without their own code; C85.1A is for B-cell lymphoma where the subtype is unknown
  • C85.9x (Non-Hodgkin lymphoma, unspecified): C85.8 indicates a specified type; C85.9 is fully unspecified
  • Z85.79 (Personal history of lymphoid neoplasms): Use for fully resolved disease; C85.8A indicates active remission monitoring

Child Codes

Code Hierarchy

C85.8A code history

Code setChange
FY2025 (effective Oct 1, 2024)Added to the code set

Source: official CMS ICD-10-CM order and addenda files, FY2016 through FY2027.

Because C85.8A 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.

C85.8A maps to CMS-HCC V28 category 21, Lymphoma and Other Cancers. See the ICD-10 to HCC mapping hub for how the V28 crosswalk works. Because C85.8A carries a payment HCC, you can see what it adds to a RAF score and check the documentation the chart needs before it is submitted.

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