C92.21
BillableAtypical chronic myeloid leukemia, BCR/ABL-negative, in remission
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is C92.21 an HCC code?
Yes. C92.21 maps to Lung and Other Severe Cancers under the CMS-HCC V28 risk adjustment model (and Lung and Other Severe Cancers under V24).
HCC Category Mapping
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 C92.21
For C92.21 to 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 C92.21 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
C92.21 is the ICD-10-CM diagnosis code for atypical chronic myeloid leukemia, bcr/abl-negative, in remission. A rare type of myeloid leukemia without the typical genetic mutation, where the patient's cancer is in remission. C92.21 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, C92.21 maps to Lung and Other Severe Cancers (HCC 20) with a community, non-dual, aged base RAF weight of 0.000. Under the older V24 model, C92.21 mapped to the same category but with a base RAF weight of 0.973 — V28 recalibrated weights across the entire model. 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.
Verify remission status is explicitly documented by the physician. Because C92.21 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 C92.21 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify remission status is explicitly documented by the physician
- •Ensure BCR/ABL-negative status is confirmed in diagnostic testing
Clinical Significance
Atypical chronic myeloid leukemia, BCR/ABL-negative, in remission indicates that this rare myelodysplastic/myeloproliferative neoplasm has responded to treatment. Remission in aCML is uncommon given the limited treatment options and aggressive disease biology. Allogeneic stem cell transplantation is the only potentially curative approach, and remission may be achieved through transplant or hypomethylating agent therapy.
Documentation Requirements
- ✓Documentation must confirm BCR/ABL-negative status and explicitly state remission status with supporting evidence including normalized blood counts and bone marrow findings.
- ✓The treatment that achieved remission (transplant, hypomethylating agents, or other therapy) and date of remission should be recorded.
- ✓Ongoing surveillance plan and GVHD management (if post-transplant) must be documented.