C92.30
BillableMyeloid sarcoma, not having achieved remission
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is C92.30 an HCC code?
Yes. C92.30 maps to Metastatic Cancer and Acute Leukemia 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 C92.30
For C92.30 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 C92.30 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
C92.30 is the ICD-10-CM diagnosis code for myeloid sarcoma, not having achieved remission. A solid tumor made of myeloid cancer cells (usually found outside the bone marrow) that has not responded to treatment. C92.30 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, C92.30 maps to Metastatic Cancer and Acute Leukemia (HCC 17) with a community, non-dual, aged base RAF weight of 0.368. Under the older CMS-HCC V24 model, C92.30 maps to Lung and Other Severe Cancers (HCC 9) with a community, non-dual, aged base RAF weight of 0.973. 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.
Myeloid sarcoma is also called granulocytic sarcoma or chloroma; document the site of the tumor. Because C92.30 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 C92.30 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Myeloid sarcoma is also called granulocytic sarcoma or chloroma; document the site of the tumor
- •Confirm that remission has not been achieved in the documentation
Clinical Significance
Myeloid sarcoma (also known as granulocytic sarcoma or chloroma) is a rare extramedullary tumor composed of immature myeloid cells, typically associated with or preceding acute myeloid leukemia. It can occur in virtually any anatomic site including skin, bone, lymph nodes, gastrointestinal tract, and central nervous system. The 'not in remission' status indicates active tumor burden requiring systemic treatment, as local therapy alone is generally insufficient.
Documentation Requirements
- ✓Documentation must identify the specific anatomic site(s) of the myeloid sarcoma and confirm the myeloid lineage by immunohistochemistry (MPO, CD68, CD117, lysozyme).
- ✓Association with concurrent or prior AML should be documented.
- ✓Biopsy confirmation is essential as myeloid sarcoma can mimic other malignancies.
- ✓Staging workup including bone marrow biopsy and imaging to assess for concurrent AML must be recorded.