C92.22
BillableAtypical chronic myeloid leukemia, BCR/ABL-negative, in relapse
HCC Category Mapping
V28HCC 20 — Lung and Other Severe Cancers
0.000V24HCC 9 — Lung and Other Severe Cancers
0.973ESRDHCC 9 — Lung and Other Severe Cancers
0.000RxHCCHCC 19 — Lymphoma and Other Cancers
0.000What This Code Means
A rare type of myeloid leukemia without the typical genetic mutation that has returned after remission.
Coding Tips
- •Document both the BCR/ABL-negative status and relapse status clearly
- •Relapse indicates the cancer has returned after a period of remission
Clinical Significance
Atypical chronic myeloid leukemia, BCR/ABL-negative, in relapse indicates recurrence of this rare myelodysplastic/myeloproliferative neoplasm after prior remission. Relapsed aCML carries a very poor prognosis with extremely limited treatment options. Post-transplant relapse may require donor lymphocyte infusions or second transplant, while relapse after non-transplant therapy has few effective salvage options.
Documentation Requirements
- ✓Documentation must confirm prior remission and current relapse with evidence of recurrent dysplastic granulocytic proliferation.
- ✓BCR/ABL-negative status should be reconfirmed at relapse.
- ✓For post-transplant relapse, chimerism studies showing decreasing donor fraction should be documented.
- ✓Updated molecular testing at relapse may reveal new mutations relevant to treatment selection.
Commonly Confused Codes
Code Hierarchy
└C92Myeloid leukemia└C92.2Atypical chronic myeloid leukemia, BCR/ABL-negative└C92.22Atypical chronic myeloid leukemia, BCR/ABL-negative, in relapse
└C92.22Atypical chronic myeloid leukemia, BCR/ABL-negative, in relapse