C86.10

HCC Category Mapping

What This Code Means

This is a rare type of blood cancer that affects T-cells and involves both the liver and spleen, and the patient's cancer has not gone into remission (improvement) with treatment. It is an aggressive form of lymphoma that typically affects young adults.

Coding Tips

• •Ensure documentation clearly states the remission status - this code specifically indicates 'not having achieved remission,' so verify the clinical record confirms the cancer has not responded to treatment before assigning this code
• •Do not use this code if remission has been achieved; instead use C86.11 for remission status or C86.12 for remission status unknown

Clinical Significance

Hepatosplenic T-cell lymphoma is an extremely rare and aggressive extranodal lymphoma that predominantly infiltrates the liver and spleen sinusoids without lymph node involvement. It typically affects young adults, particularly those on chronic immunosuppressive therapy for inflammatory bowel disease or post-transplant. The disease carries a very poor prognosis with median survival under two years when remission is not achieved.

Documentation Requirements

• ✓Documentation must confirm hepatosplenic T-cell lymphoma through liver or spleen biopsy with immunophenotyping showing gamma-delta or alpha-beta T-cell lineage.
• ✓Hepatosplenomegaly measurements, peripheral blood findings (cytopenias), bone marrow involvement status, treatment regimen, and explicit statement of non-remission status are required.

Commonly Confused Codes