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C86.61 ICD-10-CM Code: Primary cutaneous CD30-positive T-cell proliferations, in remission

C86.61 maps to CMS-HCC V28 20. A source-labeled RAF reference is available. Confirm the documented diagnosis and applicable coding requirements. MEAT criteria · RAF Calculator · free HCC coding tools

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Code lookupC86.61

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

C86.61

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

Primary cutaneous CD30-positive T-cell proliferations, in remission

A type of skin cancer involving abnormal T-cells that are CD30-positive and have responded well to treatment with no signs of disease remaining.

Buddy the Bee presenting code insight

Buddy Insight

Primary cutaneous CD30-positive T-cell proliferations in remission indicates the skin lymphoma has responded to treatment with resolution of active lesions.

OverviewRisk ModelsCode BookDocumentationAuditNotesEdition comparison

CMS-HCC V28

HCC 20

Coefficient HCC 20: 1.136 (Community Non-Dual Aged (CNA))

CMS-HCC V24

Historical

Historical

Not used for CY2026 payment

ACA/HHS

HCC 010

Code-level coefficient reference

ESRD/PACE

HCC 10

Code-level coefficient reference

RXHCC

HCC 21

Code-level coefficient reference

Code Book Path

Official
C86Other specified types of T/NK-cell lymphomaC86.6Primary cutaneous CD30-positive T-cell proliferationsC86.61Primary cutaneous CD30-positive T-cell proliferations, in remission

Inclusion Terms

Official
  • Lymphomatoid papulosisInherited from C86.6
  • Primary cutaneous anaplastic large cell lymphomaInherited from C86.6
  • Primary cutaneous CD30-positive large T-cell lymphomaInherited from C86.6

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

Official
C86.60Primary cutaneous CD30-positive T-cell proliferations not having achieved remission

Includes

Official

No Includes notes are included in this display for C86.61. Check the code and parent instructions in the Code Book.

Excludes 1

Official
  • anaplastic large cell lymphoma, ALK negative (C84.7-)Inherited from C86
  • anaplastic large cell lymphoma, ALK positive (C84.6-)Inherited from C86
  • mature T/NK-cell lymphomas (C84.-)Inherited from C86
  • other specified types of non-Hodgkin lymphoma (C85.8-)Inherited from C86

Code First

Official

No Code First sequencing instructions are included in this display for C86.61. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for C86.61. Check the code and parent instructions in the Code Book.

Code Also

Official

No Code Also instructions are included in this display for C86.61. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance
Provider must explicitly document remission with evidence of resolved skin lesions on clinical examination.
The original diagnosis confirming CD30-positive T-cell proliferation must be in the record.
Dermatologic surveillance plan and any concern for transformation to a more aggressive lymphoma should be documented.

MEAT Support

HCC Buddy guidance
Provider must explicitly document remission with evidence of resolved skin lesions on clinical examination.
The original diagnosis confirming CD30-positive T-cell proliferation must be in the record.
Dermatologic surveillance plan and any concern for transformation to a more aggressive lymphoma should be documented.

Audit Caution

HCC Buddy guidance
Lymphomatoid papulosis naturally waxes and wanes
temporary resolution of lesions does not necessarily mean remission. Ensure remission is a physician-documented clinical determination. Continue surveillance coding as these conditions may transform into more aggressive lymphomas over time.

Common Mistakes

HCC Buddy guidance
C86.60 (same condition not in remission) indicates active disease.
Z85.79 (personal history of malignant neoplasm of lymphoid tissue) should only be used for definitively cured disease.
C84.A (cutaneous T-cell lymphoma, unspecified) is less specific.

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 C86.61 an HCC code?

Yes. C86.61 (Primary cutaneous CD30-positive T-cell proliferations, in remission) maps to HCC 20, Lung and Other Severe Cancers under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 1.136. 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: C86.61 is billable and maps to V28 HCC 20, Lung and Other Severe Cancers. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code
C86.61
Description
Primary cutaneous CD30-positive T-cell proliferations, in remission
HCC (V28)
HCC 20 — Lung and Other Severe Cancers
RAF reference coefficient
1.136
Billable
Yes
Payment year
2026

HCC Category Mapping

V28HCC 20, Lung and Other Severe Cancers
1.136
ESRDHCC 10, Lymphoma and Other Cancers
Not separately weighted
RxHCCHCC 21, Lymphomas and Other Hematologic Cancers
Not separately weighted

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 C86.61 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for C86.61

For C86.61, 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

C86.61 is the ICD-10-CM diagnosis code for primary cutaneous cd30-positive t-cell proliferations, in remission. A type of skin cancer involving abnormal T-cells that are CD30-positive and have responded well to treatment with no signs of disease remaining. C86.61 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, C86.61 maps to Lung and Other Severe Cancers (HCC 20) with a source-labeled community, non-dual, aged reference coefficient of 1.136. 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.

This code specifically indicates remission status; use C86.60 if remission status is unknown or not achieved. For C86.61, 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 C86.61 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • •This code specifically indicates remission status; use C86.60 if remission status is unknown or not achieved
  • •Document the specific type of cutaneous lymphoma and current treatment response in the medical record

Clinical Significance

Primary cutaneous CD30-positive T-cell proliferations in remission indicates the skin lymphoma has responded to treatment with resolution of active lesions. The generally favorable prognosis of primary cutaneous CD30-positive disease means remission is achievable in many patients. However, some entities in this spectrum (particularly lymphomatoid papulosis) have a characteristically relapsing-remitting course requiring ongoing dermatologic surveillance.

Documentation Requirements

  • ✓Provider must explicitly document remission with evidence of resolved skin lesions on clinical examination.
  • ✓The original diagnosis confirming CD30-positive T-cell proliferation must be in the record.
  • ✓Dermatologic surveillance plan and any concern for transformation to a more aggressive lymphoma should be documented.

Commonly Confused Codes

  • •C86.60 (same condition not in remission) indicates active disease.
  • •Z85.79 (personal history of malignant neoplasm of lymphoid tissue) should only be used for definitively cured disease.
  • •C84.A (cutaneous T-cell lymphoma, unspecified) is less specific.

Child Codes

C86.60Primary cutaneous CD30-positive T-cell proliferations not having achieved remission
HCC 20
C86.61Primary cutaneous CD30-positive T-cell proliferations, in remission
HCC 20

Code Hierarchy

└C86Other specified types of T/NK-cell lymphoma└C86.6Primary cutaneous CD30-positive T-cell proliferations└C86.61Primary cutaneous CD30-positive T-cell proliferations, in remission
└C86.61Primary cutaneous CD30-positive T-cell proliferations, in remission

C86.61 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.

Also searched as

  • C86 61
  • C8661

For C86.61, 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.

C86.61 maps to CMS-HCC V28 category 20, Lung and Other Severe Cancers. See the ICD-10 to HCC mapping hub for how the V28 crosswalk works. The mapping identifies a payment HCC category for C86.61. Review its source-labeled HCC coefficient above, check the RAF Calculator with complete member context for CMS-HCC V28 PY2026, and confirm the documentation the chart needs before the code is submitted. HCC Buddy shows no RAF score unless every required source and calculation check passes.

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