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C88.40 ICD-10-CM Code: Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue [MALT-lymphoma] not having achieved remission

C88.40 maps to CMS-HCC V28 21 (RAF 0.671). Documentation must support MEAT. MEAT criteria · RAF calculator · HCC coding software

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

C88.40

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

Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue [MALT-lymphoma] not having achieved remission

A type of lymphoma affecting mucous membranes and associated lymphoid tissue (such as stomach or salivary glands) that has not responded adequately to treatment.

Buddy the Bee presenting code insight

Buddy Insight

Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) is the most common type of marginal zone lymphoma, frequently arising in the stomach in association with Helicobacter pylori infection.

CMS-HCC V28

HCC 21

RAF 0.671

CMS-HCC V24

HCC 10

RAF 0.675

ACA/HHS

HCC 10

Varies by metal level

ESRD/PACE

HCC 10

RAF 0.111

RXHCC

HCC 21

RAF 0.410

Code Book Path

Official
C88Malignant immunoproliferative diseases and certain other B-cell lymphomas
C88.4Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue [MALT-lymphoma]
C88.40Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue [MALT-lymphoma] not having achieved remission

Inclusion Terms

Official
  • Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue [MALT-lymphoma] NOS
  • Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue [MALT-lymphoma] with failed remission
  • Lymphoma of bronchial-associated lymphoid tissue [BALT-lymphoma] NOS
  • Lymphoma of bronchial-associated lymphoid tissue [BALT-lymphoma] not having achieved remission
  • Lymphoma of bronchial-associated lymphoid tissue [BALT-lymphoma] with failed remission

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for C88.40 in this effective period.

Related Child Codes

Official
C88.41Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue [MALT-lymphoma], in remission

Includes

Official

ICD-10-CM does not list Includes notes for C88.40 in this effective period.

Excludes 1

Official
  • high malignant (diffuse large B-cell) lymphoma (C83.3-)

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for C88.40 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for C88.40 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for C88.40 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
Documentation must include biopsy with immunohistochemistry confirming marginal zone B-cell lymphoma involving mucosal tissue.
The specific anatomical site, Helicobacter pylori status (particularly for gastric MALT), staging workup, treatment approach, eradication therapy results, and non-remission status must be documented.

MEAT Support

HCC Buddy guidance
Documentation must include biopsy with immunohistochemistry confirming marginal zone B-cell lymphoma involving mucosal tissue.
The specific anatomical site, Helicobacter pylori status (particularly for gastric MALT), staging workup, treatment approach, eradication therapy results, and non-remission status must be documented.

Audit Caution

HCC Buddy guidance
Gastric MALT lymphoma associated with Helicobacter pylori may respond to antibiotic eradication therapy alone
document whether eradication was attempted and the response. Do not confuse MALT lymphoma with diffuse large B-cell lymphoma, which may arise from transformation of MALT lymphoma. Ensure the specific mucosal site is documented for complete clinical characterization.

Common Mistakes

HCC Buddy guidance
C88.41 (MALT lymphoma in remission) requires documented remission.
C83.00-C83.09 (small cell B-cell lymphoma) is a different B-cell lymphoma subtype.
C16.x (malignant neoplasm of stomach) applies to gastric carcinoma, not lymphoma.
C88.30 (immunoproliferative small intestinal disease) is a related but distinct entity.

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 C88.40 an HCC code?

Yes. C88.40 (Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue [MALT-lymphoma] not having achieved remission) maps to Lymphoma and Other Cancers under the CMS-HCC V28 risk adjustment model (and Lymphoma and Other Cancers under V24), with a community non-dual aged RAF of 0.671. It is billable for payment year 2026.

Coder answer: C88.40 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
C88.40
Description
Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue [MALT-lymphoma] not having achieved remission
HCC (V28)
HCC 21 — Lymphoma and Other Cancers
RAF
0.671
Billable
Yes
Payment year
2026

HCC Category Mapping

V28HCC 21, Lymphoma and Other Cancers
0.671
V24HCC 10, Lymphoma and Other Cancers
0.675
ESRDHCC 10, Lymphoma and Other Cancers
0.111
RxHCCHCC 21, Hodgkin Lymphoma and Other Cancers
0.410

Each model's RAF is its CMS base weight for that model's standard population, so 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 segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.

Work C88.40 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for C88.40

For C88.40 to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically, it has to be re-documented and supported each calendar year.

  • 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

Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed C88.40 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

C88.40 is the ICD-10-CM diagnosis code for extranodal marginal zone b-cell lymphoma of mucosa-associated lymphoid tissue [malt-lymphoma] not having achieved remission. A type of lymphoma affecting mucous membranes and associated lymphoid tissue (such as stomach or salivary glands) that has not responded adequately to treatment. C88.40 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, C88.40 maps to Lymphoma and Other Cancers (HCC 21) with a community, non-dual, aged base RAF weight of 0.671. Under the older V24 model, C88.40 mapped to the same category but with a base RAF weight of 0.675, V28 recalibrated weights across the entire model. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition.

Use C88.40 when the provider wording supports extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue [MALT-lymphoma] not having achieved remission. Check the FY2026 tabular notes and the full code path before the final code choice. Because C88.40 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. 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, RAF weights, and MEAT documentation criteria for C88.40 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Use C88.40 when the provider wording supports extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue [MALT-lymphoma] not having achieved remission. Check the FY2026 tabular notes and the full code path before the final code choice.
  • For this DOS, capture the provider's current assessment and the care action documented for extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue [MALT-lymphoma] not having achieved remission. Keep the checklist tied to the note.
  • Do not swap C88.40 with C88.41. The FY2026 tabular describes C88.41 as extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue [MALT-lymphoma], in remission. Follow the documented detail.
  • C88.40 maps to V28 HCC 21, Lymphoma and Other Cancers. The mapping does not replace the documentation review. The code still has to match the note.
  • Ask Buddy to show the official notes for C88.40 or compare its code path with C88.41.

Clinical Significance

Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) is the most common type of marginal zone lymphoma, frequently arising in the stomach in association with Helicobacter pylori infection. Other common sites include the salivary glands, thyroid, ocular adnexa, and lungs, each with distinct etiologies. Non-remission status indicates the lymphoma persists despite treatment, which may include Helicobacter pylori eradication or chemotherapy.

Documentation Requirements

  • Documentation must include biopsy with immunohistochemistry confirming marginal zone B-cell lymphoma involving mucosal tissue.
  • The specific anatomical site, Helicobacter pylori status (particularly for gastric MALT), staging workup, treatment approach, eradication therapy results, and non-remission status must be documented.

Commonly Confused Codes

  • C88.41 (MALT lymphoma in remission) requires documented remission.
  • C83.00-C83.09 (small cell B-cell lymphoma) is a different B-cell lymphoma subtype.
  • C16.x (malignant neoplasm of stomach) applies to gastric carcinoma, not lymphoma.
  • C88.30 (immunoproliferative small intestinal disease) is a related but distinct entity.

Child Codes

Code Hierarchy

C88.40 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.

Because C88.40 maps to a payment HCC, the documentation must also satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's risk adjustment score.

C88.40 maps to CMS-HCC V28 category 21, Lymphoma and Other Cancers. See the ICD-10 to HCC mapping hub for how the V28 crosswalk works. Because C88.40 carries a payment HCC, you can see what it adds to a RAF score and check the documentation the chart needs before it is submitted.

Work C88.40 in HCC Buddy

Open C88.40 in the Code Book for the full Index-to-Tabular path, MEAT checklist, and V28 HCC mapping, or in the Encoder to code from a keyword search. Pro includes 7 days to try everything, no card required.