C92.00 ICD-10-CM Code: Acute myeloblastic leukemia, not having achieved remission
C92.00 maps to CMS-HCC V28 17. A source-labeled RAF reference is available. Confirm the documented diagnosis and applicable coding requirements. 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)
C92.00
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceAcute myeloblastic leukemia, not having achieved remission
An acute blood cancer of myeloid cells that has not responded to treatment or is actively progressing.
Buddy Insight
Acute myeloblastic leukemia (AML) not in remission is a rapidly progressive hematologic malignancy characterized by clonal proliferation of immature myeloid cells (blasts) in the bone marrow, with blast count of 20% or more.
CMS-HCC V28
MappedHCC 17
Coefficient HCC 17: 4.209 (Community Non-Dual Aged (CNA))
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
MappedHCC 008
Code-level coefficient reference
ESRD/PACE
MappedHCC 8
Code-level coefficient reference
RXHCC
MappedHCC 19
Code-level coefficient reference
Code Book Path
Inclusion Terms
Official- Acute myeloblastic leukemia with failed remission
- Acute myeloblastic leukemia NOS
- Acute myeloblastic leukemia, minimal differentiationInherited from C92.0
- Acute myeloblastic leukemia (with maturation)Inherited from C92.0
- Acute myeloblastic leukemia 1/ETOInherited from C92.0
- Acute myeloblastic leukemia M0Inherited from C92.0
- Acute myeloblastic leukemia M1Inherited from C92.0
- Acute myeloblastic leukemia M2Inherited from C92.0
- Acute myeloblastic leukemia with t(8;21)Inherited from C92.0
- Acute myeloblastic leukemia (without a FAB classification) NOSInherited from C92.0
- Refractory anemia with excess blasts in transformation [RAEB T]Inherited from C92.0
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
Includes
Official- granulocytic leukemiaInherited from C92
- myelogenous leukemiaInherited from C92
Excludes 1
Official- personal history of leukemia (Z85.6)Inherited from C92, C92.0
- acute exacerbation of chronic myeloid leukemia (C92.10)Inherited from C92, C92.0
- refractory anemia with excess of blasts not in transformation (D46.2-)Inherited from C92, C92.0
Code First
OfficialNo Code First sequencing instructions are included in this display for C92.00. Check the code and parent instructions in the Code Book.
Use Additional
OfficialNo Use Additional Code instructions are included in this display for C92.00. Check the code and parent instructions in the Code Book.
Code Also
Official- , if applicable, pancytopenia (acquired) (D61.818)Inherited from C92
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
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 C92.00 an HCC code?
Yes. C92.00 (Acute myeloblastic leukemia, not having achieved remission) maps to HCC 17, Cancer Metastatic to Lung, Liver, Brain, and Other Organs; Acute Myeloid Leukemia Except Promyelocytic under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 4.209. 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: C92.00 is billable and maps to V28 HCC 17, Cancer Metastatic to Lung, Liver, Brain, and Other Organs; Acute Myeloid Leukemia Except Promyelocytic. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.
- Code
- C92.00
- Description
- Acute myeloblastic leukemia, not having achieved remission
- HCC (V28)
- HCC 17 — Cancer Metastatic to Lung, Liver, Brain, and Other Organs; Acute Myeloid Leukemia Except Promyelocytic
- RAF reference coefficient
- 4.209
- Billable
- Yes
- Payment year
- 2026
HCC Category Mapping
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 C92.00 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →
MEAT review for C92.00
For C92.00, 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
C92.00 is the ICD-10-CM diagnosis code for acute myeloblastic leukemia, not having achieved remission. An acute blood cancer of myeloid cells that has not responded to treatment or is actively progressing. C92.00 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, C92.00 maps to Cancer Metastatic to Lung, Liver, Brain, and Other Organs; Acute Myeloid Leukemia Except Promyelocytic (HCC 17) with a source-labeled community, non-dual, aged reference coefficient of 4.209. 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 acute myeloblastic leukemia without remission achievement. For C92.00, 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 C92.00 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This code specifically indicates acute myeloblastic leukemia without remission achievement
- •Verify documentation confirms 'acute' type and 'not in remission' status
Clinical Significance
Acute myeloblastic leukemia (AML) not in remission is a rapidly progressive hematologic malignancy characterized by clonal proliferation of immature myeloid cells (blasts) in the bone marrow, with blast count of 20% or more. AML is a medical emergency requiring immediate induction chemotherapy, and it carries a high risk of life-threatening complications including neutropenic infections, bleeding, and disseminated intravascular coagulation. The 'not in remission' status indicates active, uncontrolled disease.
Documentation Requirements
- ✓Documentation must confirm the acute nature of the leukemia with blast percentage, morphologic classification (FAB or WHO 2022), cytogenetic findings, and molecular mutations (FLT3, NPM1, CEBPA, IDH1/2, TP53).
- ✓Active disease status must be explicitly stated.
- ✓Treatment history, response assessment, and current supportive care needs (transfusions, growth factors, antimicrobials) should be documented.
Commonly Confused Codes
- •C92.40 (acute promyelocytic leukemia, not in remission) is a specific AML subtype with unique treatment.
- •C92.50 (acute myelomonocytic leukemia, not in remission) has monocytic differentiation.
- •C92.60 (AML with 11q23-abnormality) is a cytogenetically defined subtype.
- •C92.A0 (AML with multilineage dysplasia) has myelodysplastic features.
- •C92.90 (myeloid leukemia, unspecified) should not be used when acute AML is confirmed.