C85.90

HCC Category Mapping

What This Code Means

Non-Hodgkin lymphoma of an unspecified type affecting an unspecified location in the body.

Coding Tips

• •This is a less specific code; attempt to identify the site and type of lymphoma for more precise coding
• •Use only when documentation does not specify the anatomical site or lymphoma subtype

Clinical Significance

Non-Hodgkin lymphoma, unspecified, at an unspecified site is the least specific lymphoma code and should be considered a last resort when no additional information is available. This code lacks both subtype and site specificity, making it a prime candidate for coder queries to the provider. Despite its nonspecificity, it still carries significant HCC risk adjustment weight reflecting the seriousness of any lymphoma diagnosis.

Documentation Requirements

• ✓At minimum, documentation must confirm a diagnosis of non-Hodgkin lymphoma (not Hodgkin lymphoma or other hematologic malignancy)
• ✓Query provider aggressively for pathology results identifying the lymphoma subtype (B-cell vs T-cell, specific WHO classification)
• ✓Query for anatomical site of disease based on imaging, physical exam, or surgical findings
• ✓If neither subtype nor site can be determined, document the reason (e.g., pending pathology, outside records unavailable)

Commonly Confused Codes