What is ICD-10 code C92.10?

C92.10 is the ICD-10-CM diagnosis code for Chronic myeloid leukemia, BCR/ABL-positive, not having achieved remission. A chronic blood cancer of myeloid cells with a specific genetic abnormality (BCR/ABL fusion) that has not achieved remission. It belongs to the ICD-10-CM chapter for neoplasms (c00-d49). C92.10 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. C92.10 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. C92.10 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. C92.10 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

What is the V28 vs V24 difference for C92.10?

CMS phased in the V28 risk adjustment model over payment years 2024 (33%), 2025 (67%), and 2026 (100%), replacing V24. V28 consolidates HCC categories, removes some lower-acuity conditions, and recalibrates RAF weights across the entire model. For C92.10, V28 maps to Colorectal, Bladder, and Other Cancers at RAF 0.000 while V24 mapped to Lung and Other Severe Cancers at RAF 0.973. Both models can still appear in legacy data and in payer-specific lookback periods.

What should coders know when reporting C92.10?

This code requires documentation of BCR/ABL positivity, typically confirmed by cytogenetics or molecular testing The BCR/ABL mutation is the hallmark of chronic myeloid leukemia and must be documented Because C92.10 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.

C92.10 ICD-10 Code: Chronic myeloid leukemia

ICD-10-CM Code View

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Code lookupC92.10Effective periodFY2026 Apr Update (Apr 1-Sep 30)

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

C92.10

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

Chronic myeloid leukemia, BCR/ABL-positive, not having achieved remission

A chronic blood cancer of myeloid cells with a specific genetic abnormality (BCR/ABL fusion) that has not achieved remission.

Buddy Insight

Chronic myeloid leukemia (CML), BCR/ABL-positive, is a myeloproliferative neoplasm characterized by the Philadelphia chromosome (t(9;22)) creating the BCR-ABL1 fusion oncogene.

CMS-HCC V28

Mapped

HCC 22

Colorectal, Bladder, and Othe...

RAF 0.0

CMS-HCC V24

Mapped

HCC 9

Lung and Other Severe Cancers

RAF 0.973

ACA/HHS

Not risk-adjusted for this model/period.

RAF 0

ESRD/PACE

Mapped

HCC 9

Lung and Other Severe Cancers

RAF 0.0

RXHCC

Mapped

HCC 15

Chronic Myeloid Leukemia

RAF 0.0

Code Trumping

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Code Book Path

Official

C92Myeloid leukemia

C92.1Chronic myeloid leukemia, BCR/ABL-positive

C92.10Chronic myeloid leukemia, BCR/ABL-positive, not having achieved remission

Inclusion Terms

Official

Chronic myeloid leukemia, BCR/ABL-positive with failed remission
Chronic myeloid leukemia, BCR/ABL-positive NOS

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for C92.10 in this effective period.

Related Child Codes

Official

C92.11Chronic myeloid leukemia, BCR/ABL-positive, in remission

C92.12Chronic myeloid leukemia, BCR/ABL-positive, in relapse

Includes

Official

ICD-10-CM does not list Includes notes for C92.10 in this effective period.

Excludes 1

Official

atypical chronic myeloid leukemia BCR/ABL-negative (C92.2-)
chronic myelomonocytic leukemia (C93.1-)
chronic myeloproliferative disease (D47.1)

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for C92.10 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for C92.10 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for C92.10 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Documentation must confirm BCR/ABL positivity by cytogenetics (Philadelphia chromosome), FISH, or molecular testing (BCR-ABL1 by PCR).

Current disease phase (chronic, accelerated, blast crisis) and treatment response should be documented using established milestones (complete hematologic response, complete cytogenetic response, major molecular response).

Current TKI therapy and tolerance/resistance issues must be recorded.

MEAT Support

HCC Buddy guidance

Documentation must confirm BCR/ABL positivity by cytogenetics (Philadelphia chromosome), FISH, or molecular testing (BCR-ABL1 by PCR).

Current TKI therapy and tolerance/resistance issues must be recorded.

Audit Caution

HCC Buddy guidance

BCR/ABL positivity must be confirmed -

do not assume based on clinical presentation alone. CML patients on TKI therapy who have not achieved major molecular response are still coded as 'not in remission.' Blast crisis of CML may be coded differently depending on the lineage of blast cells. Do not confuse CML with other chronic myeloproliferative neoplasms (polycythemia vera, essential thrombocythemia, myelofibrosis).

Common Mistakes

HCC Buddy guidance

C92.20 (atypical CML, BCR/ABL-negative) is a distinct entity without the Philadelphia chromosome.

C92.00 (acute myeloblastic leukemia) should be used instead if CML has transformed to blast crisis with myeloid phenotype.

C92.90 (myeloid leukemia, unspecified) should not be used when CML is specifically diagnosed.

D47.1 (chronic myeloproliferative disease, not elsewhere classified) is a different category.

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.

Is C92.10 an HCC code?

Yes. C92.10 maps to Colorectal, Bladder, and Other Cancers under the CMS-HCC V28 risk adjustment model (and Lung and Other Severe Cancers under V24).

HCC Category Mapping

V28HCC 22, Colorectal, Bladder, and Other Cancers

0.000

V24HCC 9, Lung and Other Severe Cancers

0.973

ESRDHCC 9, Lung and Other Severe Cancers

0.000

RxHCCHCC 15, Chronic Myeloid Leukemia

0.000

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 C92.10

For C92.10to 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 C92.10 during that encounter, not just copy-forwarded from a problem list.

What This Code Means

C92.10 is the ICD-10-CM diagnosis code for chronic myeloid leukemia, bcr/abl-positive, not having achieved remission. A chronic blood cancer of myeloid cells with a specific genetic abnormality (BCR/ABL fusion) that has not achieved remission. C92.10 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, C92.10 maps to Colorectal, Bladder, and Other Cancers (HCC 22) with a community, non-dual, aged base RAF weight of 0.000. Under the older CMS-HCC V24 model, C92.10 maps to Lung and Other Severe Cancers (HCC 9) with a community, non-dual, aged base RAF weight of 0.973. 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.

This code requires documentation of BCR/ABL positivity, typically confirmed by cytogenetics or molecular testing. Because C92.10 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 C92.10 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•This code requires documentation of BCR/ABL positivity, typically confirmed by cytogenetics or molecular testing
•The BCR/ABL mutation is the hallmark of chronic myeloid leukemia and must be documented

Clinical Significance

Chronic myeloid leukemia (CML), BCR/ABL-positive, is a myeloproliferative neoplasm characterized by the Philadelphia chromosome (t(9;22)) creating the BCR-ABL1 fusion oncogene. The 'not in remission' status indicates detectable disease activity, which in the tyrosine kinase inhibitor (TKI) era may range from suboptimal molecular response to blast crisis. CML has three phases (chronic, accelerated, blast crisis) with dramatically different prognoses.

Documentation Requirements

✓Documentation must confirm BCR/ABL positivity by cytogenetics (Philadelphia chromosome), FISH, or molecular testing (BCR-ABL1 by PCR).
✓Current disease phase (chronic, accelerated, blast crisis) and treatment response should be documented using established milestones (complete hematologic response, complete cytogenetic response, major molecular response).
✓Current TKI therapy and tolerance/resistance issues must be recorded.

Commonly Confused Codes

•C92.20 (atypical CML, BCR/ABL-negative) is a distinct entity without the Philadelphia chromosome.
•C92.00 (acute myeloblastic leukemia) should be used instead if CML has transformed to blast crisis with myeloid phenotype.
•C92.90 (myeloid leukemia, unspecified) should not be used when CML is specifically diagnosed.
•D47.1 (chronic myeloproliferative disease, not elsewhere classified) is a different category.