C86.20

HCC Category Mapping

What This Code Means

This is a rare type of cancer that starts in T-cells (immune cells) in the intestines and has not gone into remission or has returned after treatment. It is an aggressive form of lymphoma that affects the digestive tract.

Coding Tips

• •Verify documentation clearly states 'not having achieved remission' or 'refractory' status, as this distinguishes it from C86.21 (in remission); query the provider if remission status is unclear
• •Ensure this code is used only for enteropathy-type intestinal T-cell lymphoma specifically; do not confuse with other T-cell lymphomas or other GI lymphomas that would have different codes

Clinical Significance

Enteropathy-type intestinal T-cell lymphoma (EATL) is a rare, aggressive lymphoma arising from intraepithelial T-lymphocytes of the small intestine, strongly associated with celiac disease. Patients who have not achieved remission face a very poor prognosis with high rates of intestinal perforation, obstruction, and hemorrhage. This lymphoma often presents as an acute complication in patients with longstanding or refractory celiac disease.

Documentation Requirements

• ✓Documentation must confirm the EATL diagnosis through intestinal biopsy with immunohistochemistry.
• ✓Association with celiac disease or refractory sprue should be documented when present.
• ✓Disease extent, staging, surgical interventions for complications, treatment response, and explicit non-remission status must be recorded.

Commonly Confused Codes