C88.41
BillableExtranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue [MALT-lymphoma], in remission
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is C88.41 an HCC code?
Yes. C88.41 maps to Lymphoma and Other Cancers under the CMS-HCC V28 risk adjustment model (and Lymphoma and Other Cancers under V24).
HCC Category Mapping
RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. 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.
MEAT Criteria for C88.41
For C88.41to 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 C88.41 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
C88.41 is the ICD-10-CM diagnosis code for extranodal marginal zone b-cell lymphoma of mucosa-associated lymphoid tissue [malt-lymphoma], in remission. A type of lymphoma affecting mucous membranes and associated lymphoid tissue that has responded well to treatment with no active disease. C88.41 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, C88.41 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, C88.41 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.
Document whether remission was achieved through antibiotic therapy alone or required chemotherapy. Because C88.41 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 C88.41 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Document whether remission was achieved through antibiotic therapy alone or required chemotherapy
- •Include follow-up endoscopy results and H. pylori status in the medical record
Clinical Significance
MALT lymphoma in remission indicates successful treatment response, which for gastric MALT may have been achieved through Helicobacter pylori eradication therapy alone. Non-gastric MALT lymphomas in remission may have required radiation or chemotherapy. Remission in MALT lymphoma generally carries a favorable long-term prognosis, though surveillance for relapse and potential transformation to aggressive lymphoma is still necessary.
Documentation Requirements
- ✓Remission must be explicitly documented with supporting evidence from endoscopy and biopsy (for gastric MALT) or imaging for other sites showing resolution of disease.
- ✓Helicobacter pylori eradication status (post-treatment testing), surveillance schedule, and any ongoing monitoring must be documented.