C92.31
BillableMyeloid sarcoma, in remission
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is C92.31 an HCC code?
Yes. C92.31 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 C92.31
For C92.31 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 C92.31 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
C92.31 is the ICD-10-CM diagnosis code for myeloid sarcoma, in remission. A solid tumor made of myeloid cancer cells that is currently in remission. C92.31 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, C92.31 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, C92.31 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.
Document the anatomical site of the myeloid sarcoma when possible. Because C92.31 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 C92.31 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Document the anatomical site of the myeloid sarcoma when possible
- •Verify remission status is explicitly stated in the clinical documentation
Clinical Significance
Myeloid sarcoma in remission indicates resolution of the extramedullary myeloid tumor after treatment. Remission requires both local tumor resolution and absence of systemic AML in the bone marrow. Patients with myeloid sarcoma in remission require surveillance for late relapse, which may present as recurrent extramedullary disease, new bone marrow-based AML, or both.
Documentation Requirements
- ✓Provider must document resolution of the extramedullary mass by imaging and normalization of the bone marrow biopsy.
- ✓The treatment that achieved remission and date of response should be recorded.
- ✓Ongoing surveillance plan including imaging of prior tumor sites and bone marrow monitoring must be documented.
- ✓Post-remission therapy (consolidation chemotherapy or transplant consideration) should be noted.