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C92.20 ICD-10-CM Code: Atypical chronic myeloid leukemia, BCR/ABL-negative, not having achieved remission

C92.20 maps to CMS-HCC V28 20. A source-labeled RAF reference is available. Confirm the documented diagnosis and applicable coding requirements. MEAT criteria · RAF Calculator · HCC Buddy coding tools

ICD-10-CM Code View

HCC Buddy Code Card

Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.

Code lookupC92.20

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

C92.20

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

Atypical chronic myeloid leukemia, BCR/ABL-negative, not having achieved remission

A rare type of myeloid leukemia without the typical genetic mutation, where the patient has not achieved remission.

Buddy the Bee presenting code insight

Buddy Insight

Atypical chronic myeloid leukemia (aCML), BCR/ABL-negative, is a rare myelodysplastic/myeloproliferative neoplasm that shares clinical features with CML but lacks the Philadelphia chromosome and BCR-ABL1 fusion gene.

OverviewRisk ModelsCode BookDocumentationAuditNotesEdition comparison

CMS-HCC V28

HCC 20

Coefficient HCC 20: 1.136 (Community Non-Dual Aged (CNA))

CMS-HCC V24

Historical

Historical

Not used for CY2026 payment

ACA/HHS

HCC 009

Code-level coefficient reference

ESRD/PACE

HCC 9

Code-level coefficient reference

RXHCC

HCC 19

Code-level coefficient reference

Code Book Path

Official
C92Myeloid leukemiaC92.2Atypical chronic myeloid leukemia, BCR/ABL-negativeC92.20Atypical chronic myeloid leukemia, BCR/ABL-negative, not having achieved remission

Inclusion Terms

Official
  • Atypical chronic myeloid leukemia, BCR/ABL-negative with failed remission
  • Atypical chronic myeloid leukemia, BCR/ABL-negative NOS

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

Official
C92.21Atypical chronic myeloid leukemia, BCR/ABL-negative, in remissionC92.22Atypical chronic myeloid leukemia, BCR/ABL-negative, in relapse

Includes

Official
  • granulocytic leukemiaInherited from C92
  • myelogenous leukemiaInherited from C92

Excludes 1

Official
  • personal history of leukemia (Z85.6)Inherited from C92

Code First

Official

No Code First sequencing instructions are included in this display for C92.20. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for C92.20. 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

HCC Buddy guidance
Documentation must confirm BCR/ABL-negative status by cytogenetics, FISH, or molecular testing.
The diagnosis requires granulocytic dysplasia, leukocytosis with immature granulocyte precursors, and absence of BCR-ABL1, PDGFRA, PDGFRB, or FGFR1 rearrangements.
Molecular testing for SETBP1 and ETNK1 mutations (common in aCML) should be documented when performed.
Active disease status and treatment response must be recorded.

MEAT Support

HCC Buddy guidance
Documentation must confirm BCR/ABL-negative status by cytogenetics, FISH, or molecular testing.
The diagnosis requires granulocytic dysplasia, leukocytosis with immature granulocyte precursors, and absence of BCR-ABL1, PDGFRA, PDGFRB, or FGFR1 rearrangements.
Molecular testing for SETBP1 and ETNK1 mutations (common in aCML) should be documented when performed.
Active disease status and treatment response must be recorded.

Audit Caution

HCC Buddy guidance
The key distinguishing feature is BCR/ABL negativity -
this must be confirmed before assigning this code. Do not assume aCML based on a CML-like presentation without molecular testing. TKI therapy (imatinib) is not effective for aCML, unlike classic CML, making the distinction critical for treatment decisions. aCML has a significantly worse prognosis than classic CML.

Common Mistakes

HCC Buddy guidance
C92.10 (CML, BCR/ABL-positive) is the classic Philadelphia chromosome-positive disease with different treatment and prognosis.
D46 codes (myelodysplastic syndromes) lack the proliferative component.
D47.1 (chronic myeloproliferative disease, NEC) may be confused but is a different category.
C93.10 (chronic myelomonocytic leukemia) has monocytic predominance and is distinct.

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 C92.20 an HCC code?

Yes. C92.20 (Atypical chronic myeloid leukemia, BCR/ABL-negative, not having achieved remission) maps to HCC 20, Lung and Other Severe Cancers under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 1.136. 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: C92.20 is billable and maps to V28 HCC 20, Lung and Other Severe Cancers. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code
C92.20
Description
Atypical chronic myeloid leukemia, BCR/ABL-negative, not having achieved remission
HCC (V28)
HCC 20 — Lung and Other Severe Cancers
RAF reference coefficient
1.136
Billable
Yes
Payment year
2026

HCC Category Mapping

V28HCC 20, Lung and Other Severe Cancers
1.136
ESRDHCC 9, Lung and Other Severe Cancers
Not separately weighted
RxHCCHCC 19, Leukemias and Other Hematologic Cancers
Not separately weighted

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 C92.20 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for C92.20

For C92.20, 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

C92.20 is the ICD-10-CM diagnosis code for atypical chronic myeloid leukemia, bcr/abl-negative, not having achieved remission. A rare type of myeloid leukemia without the typical genetic mutation, where the patient has not achieved remission. C92.20 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, C92.20 maps to Lung and Other Severe Cancers (HCC 20) with a source-labeled community, non-dual, aged reference coefficient of 1.136. 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.

Confirm BCR/ABL-negative status is documented to distinguish from typical chronic myeloid leukemia. For C92.20, 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 C92.20 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • •Confirm BCR/ABL-negative status is documented to distinguish from typical chronic myeloid leukemia
  • •Document that remission has not been achieved; this indicates active disease

Clinical Significance

Atypical chronic myeloid leukemia (aCML), BCR/ABL-negative, is a rare myelodysplastic/myeloproliferative neoplasm that shares clinical features with CML but lacks the Philadelphia chromosome and BCR-ABL1 fusion gene. aCML typically presents with leukocytosis, multilineage dysplasia, and a worse prognosis than classic CML. The 'not in remission' status indicates ongoing active disease that is not responding to treatment.

Documentation Requirements

  • ✓Documentation must confirm BCR/ABL-negative status by cytogenetics, FISH, or molecular testing.
  • ✓The diagnosis requires granulocytic dysplasia, leukocytosis with immature granulocyte precursors, and absence of BCR-ABL1, PDGFRA, PDGFRB, or FGFR1 rearrangements.
  • ✓Molecular testing for SETBP1 and ETNK1 mutations (common in aCML) should be documented when performed.
  • ✓Active disease status and treatment response must be recorded.

Commonly Confused Codes

  • •C92.10 (CML, BCR/ABL-positive) is the classic Philadelphia chromosome-positive disease with different treatment and prognosis.
  • •D46 codes (myelodysplastic syndromes) lack the proliferative component.
  • •D47.1 (chronic myeloproliferative disease, NEC) may be confused but is a different category.
  • •C93.10 (chronic myelomonocytic leukemia) has monocytic predominance and is distinct.

Child Codes

C92.20Atypical chronic myeloid leukemia, BCR/ABL-negative, not having achieved remission
HCC 20
C92.21Atypical chronic myeloid leukemia, BCR/ABL-negative, in remission
HCC 20
C92.22Atypical chronic myeloid leukemia, BCR/ABL-negative, in relapse
HCC 20

Code Hierarchy

└C92Myeloid leukemia└C92.2Atypical chronic myeloid leukemia, BCR/ABL-negative└C92.20Atypical chronic myeloid leukemia, BCR/ABL-negative, not having achieved remission
└C92.20Atypical chronic myeloid leukemia, BCR/ABL-negative, not having achieved remission

Also searched as

  • C92 20
  • C9220

For C92.20, 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.

C92.20 maps to CMS-HCC V28 category 20, Lung and Other Severe Cancers. See the ICD-10 to HCC mapping hub for how the V28 crosswalk works. The mapping identifies a payment HCC category for C92.20. Review its source-labeled HCC coefficient above, check the RAF Calculator with complete member context for CMS-HCC V28 PY2026, and confirm the documentation the chart needs before the code is submitted. HCC Buddy shows no RAF score unless every required source and calculation check passes.

More on C92.20

Code family

Every C92 code with its CMS-HCC V28 statusMyeloid leukemia, 30 billable codes

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