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C91.4 ICD-10-CM Code: Hairy cell leukemia

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

C91.4

Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidance

Hairy cell leukemia

Hairy cell leukemia

CMS-HCC V28

0

0

RAF 0

CMS-HCC V24

0

0

RAF 0

ACA/HHS

0

0

RAF 0

ESRD/PACE

0

0

RAF 0

RXHCC

0

0

RAF 0

Code Trumping

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Code Book Path

Official
C91Lymphoid leukemia
C91.4Hairy cell leukemia

Inclusion Terms

Official
  • Leukemic reticuloendotheliosis

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for C91.4 in this effective period.

Related Child Codes

Official
C91.40Hairy cell leukemia not having achieved remission
C91.41Hairy cell leukemia, in remission
C91.42Hairy cell leukemia, in relapse

Includes

Official

ICD-10-CM does not list Includes notes for C91.4 in this effective period.

Excludes 1

Official
  • personal history of leukemia (Z85.6)

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for C91.4 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for C91.4 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for C91.4 in this effective period.

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

What This Code Means

C91.4 is the ICD-10-CM diagnosis code for hairy cell leukemia. C91.4 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).

Header codes like C91.4 cannot be reported on claims directly, they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at C91.4's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for C91.4 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Child Codes

Code Hierarchy

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