C92.41

HCC Category Mapping

What This Code Means

A rapidly developing blood cancer with abnormal promyelocytes that is currently in remission.

Coding Tips

• •Acute promyelocytic leukemia (APL) is a medical emergency; verify remission status is documented
• •This subtype often responds well to targeted therapy; document treatment response

Clinical Significance

Acute promyelocytic leukemia in remission indicates successful response to ATRA-based therapy, which is achievable in over 90% of patients who survive the initial high-risk DIC period. Remission in APL is typically assessed by molecular testing showing undetectable PML-RARA transcripts by PCR. APL has the highest cure rate among AML subtypes, and patients achieving molecular remission after consolidation have excellent long-term outcomes.

Documentation Requirements

• ✓Documentation must confirm the PML-RARA-positive diagnosis and explicit remission status, ideally with molecular remission (undetectable PML-RARA by RT-PCR).
• ✓The treatment regimen (ATRA/arsenic trioxide or ATRA/chemotherapy), date of remission, and consolidation/maintenance plan should be recorded.
• ✓Molecular monitoring schedule during post-consolidation surveillance must be documented, typically every 3 months for 2 years.

Commonly Confused Codes