C92.10

HCC Category Mapping

What This Code Means

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

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