C85.99 ICD-10-CM Code: Non-Hodgkin lymphoma, unspecified, extranodal and solid organ sites
C85.99 maps to CMS-HCC V28 21. A source-labeled RAF reference is available. Confirm the documented diagnosis and applicable coding requirements. MEAT criteria · RAF Calculator · HCC Buddy coding tools
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FY 2026 Apr update / Neoplasms (C00-D49) / Malignant neoplasms of lymphoid, hematopoietic and related tissue (C81-C96)
C85.99
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceNon-Hodgkin lymphoma, unspecified, extranodal and solid organ sites
Non-Hodgkin lymphoma of unspecified type affecting organs or tissues outside the lymph node system.
Buddy Insight
Non-Hodgkin lymphoma of unspecified type affecting extranodal and solid organ sites represents lymphoma arising in or primarily involving organs outside the lymph node system, such as the gastrointestinal tract, central nervous system, liver, bone, or skin.
CMS-HCC V28
MappedHCC 21
Coefficient HCC 21: 0.671 (Community Non-Dual Aged (CNA))
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
MappedHCC 010
Code-level coefficient reference
ESRD/PACE
MappedHCC 10
Code-level coefficient reference
RXHCC
MappedHCC 21
Code-level coefficient reference
Code Book Path
Inclusion Terms
Official- Lymphoma NOSInherited from C85.9
- Malignant lymphoma NOSInherited from C85.9
- Non-Hodgkin lymphoma NOSInherited from C85.9
Excludes 2
Official- Kaposi's sarcoma of lymph nodes (C46.3)Inherited from C81-C96
- secondary and unspecified neoplasm of lymph nodes (C77.-)Inherited from C81-C96
- secondary neoplasm of bone marrow (C79.52)Inherited from C81-C96
- secondary neoplasm of spleen (C78.89)Inherited from C81-C96
Related Codes
Includes
OfficialNo Includes notes are included in this display for C85.99. Check the code and parent instructions in the Code Book.
Excludes 1
Official- other specified types of T/NK-cell lymphoma (C86.-)Inherited from C85
- personal history of non-Hodgkin lymphoma (Z85.72)Inherited from C85
Code First
OfficialNo Code First sequencing instructions are included in this display for C85.99. Check the code and parent instructions in the Code Book.
Use Additional
OfficialNo Use Additional Code instructions are included in this display for C85.99. Check the code and parent instructions in the Code Book.
Code Also
OfficialNo Code Also instructions are included in this display for C85.99. Check the code and parent instructions in the Code Book.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
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 C85.99 an HCC code?
Yes. C85.99 (Non-Hodgkin lymphoma, unspecified, extranodal and solid organ sites) maps to HCC 21, Lymphoma and Other Cancers under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 0.671. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes. It is billable for payment year 2026.
Coder answer: C85.99 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
- C85.99
- Description
- Non-Hodgkin lymphoma, unspecified, extranodal and solid organ sites
- HCC (V28)
- HCC 21 — Lymphoma and Other Cancers
- RAF reference coefficient
- 0.671
- Billable
- Yes
- Payment year
- 2026
HCC Category Mapping
These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. 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 context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.
Work C85.99 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →
MEAT review for C85.99
For C85.99, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.
- 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
Coder workflow notes
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What This Code Means
C85.99 is the ICD-10-CM diagnosis code for non-hodgkin lymphoma, unspecified, extranodal and solid organ sites. Non-Hodgkin lymphoma of unspecified type affecting organs or tissues outside the lymph node system. C85.99 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, C85.99 maps to Lymphoma and Other Cancers (HCC 21) with a source-labeled community, non-dual, aged reference coefficient of 0.671. For CY2026 non-PACE Medicare Advantage, CMS uses 100% of the 2024 CMS-HCC model (V28). PACE uses a separate model blend. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes.
Extranodal sites include organs like liver, bone, GI tract, CNS, and other solid organs. For C85.99, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule. 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, source-labeled coefficient references, and MEAT documentation criteria for C85.99 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Extranodal sites include organs like liver, bone, GI tract, CNS, and other solid organs
- •Specify which organ(s) are involved in documentation for optimal coding accuracy
Clinical Significance
Non-Hodgkin lymphoma of unspecified type affecting extranodal and solid organ sites represents lymphoma arising in or primarily involving organs outside the lymph node system, such as the gastrointestinal tract, central nervous system, liver, bone, or skin. Extranodal NHL accounts for approximately one-third of all NHL cases and may present with organ-specific symptoms that mimic non-malignant conditions. Prognosis and treatment vary significantly depending on the organ involved.
Documentation Requirements
- ✓Provider must specify which extranodal organ or solid organ site is involved.
- ✓Pathology confirming NHL with immunohistochemistry results should be documented.
- ✓Disease stage, treatment approach (which may differ based on organ site), and response to therapy must be clearly recorded.
Commonly Confused Codes
- •C85.91-C85.98 codes are for nodal disease at specific lymph node sites and should not be used for extranodal involvement.
- •Organ-specific primary malignancy codes (e.g., C16.x for gastric cancer) should not be used for lymphoma involving these organs.
- •C88.40 (MALT lymphoma) is a more specific code for certain mucosal extranodal NHL.