C92.12

HCC Category Mapping

What This Code Means

A type of blood cancer (chronic myeloid leukemia) with a specific genetic mutation that has returned after initial treatment.

Coding Tips

• •Verify BCR/ABL positivity is documented in the pathology report before assigning this code
• •Ensure relapse status is clearly documented; do not assume relapse without explicit physician documentation

Clinical Significance

Chronic myeloid leukemia, BCR/ABL-positive, in relapse indicates loss of previously achieved treatment response, which may manifest as hematologic, cytogenetic, or molecular relapse. CML relapse while on TKI therapy may indicate development of resistance mutations (e.g., T315I) and often requires switching to an alternative TKI or consideration of allogeneic transplant. Relapse after TKI discontinuation during treatment-free remission is also captured by this code.

Documentation Requirements

• ✓Documentation must confirm prior remission and evidence of relapse, including rising BCR-ABL1 transcript levels, loss of cytogenetic response, or hematologic recurrence.
• ✓BCR-ABL1 kinase domain mutation testing should be documented at relapse to guide TKI selection.
• ✓Current disease phase (chronic, accelerated, blast crisis) must be specified, as some relapses present with disease acceleration.

Commonly Confused Codes