C92.51
BillableAcute myelomonocytic leukemia, in remission
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is C92.51 an HCC code?
Yes. C92.51 maps to Metastatic Cancer and Acute Leukemia under the CMS-HCC V28 risk adjustment model (and Metastatic Cancer and Acute Leukemia 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 C92.51
For C92.51 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 C92.51 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
C92.51 is the ICD-10-CM diagnosis code for acute myelomonocytic leukemia, in remission. A type of blood cancer (acute myelomonocytic leukemia) where the cancer cells have responded to treatment and are no longer detectable. C92.51 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, C92.51 maps to Metastatic Cancer and Acute Leukemia (HCC 17) with a community, non-dual, aged base RAF weight of 0.368. Under the older V24 model, C92.51 mapped to the same category but with a base RAF weight of 2.484 — 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.
Use this code only when documentation explicitly states the patient is in remission. Because C92.51 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 C92.51 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use this code only when documentation explicitly states the patient is in remission
- •Remission status must be clearly documented in the medical record; do not assume based on treatment alone
Clinical Significance
Acute myelomonocytic leukemia in remission indicates successful response to induction chemotherapy with resolution of the dual myeloid/monocytic proliferation and normalization of bone marrow. The M4Eo variant with inv(16) has particularly good remission rates and long-term outcomes. Post-remission consolidation therapy, including potential high-dose cytarabine cycles, is essential to reduce relapse risk.
Documentation Requirements
- ✓Documentation must confirm remission with bone marrow blasts less than 5%, resolution of monocytic component, and count recovery.
- ✓The cytogenetic subtype (particularly inv(16) status) should remain documented as it influences consolidation therapy decisions.
- ✓Minimal residual disease assessment, consolidation treatment plan, and transplant candidacy evaluation should be recorded.
Commonly Confused Codes
- •C92.50 (AMML not in remission) is for active disease.
- •C92.52 (AMML in relapse) is for recurrent disease.
- •C93.01 (acute monoblastic/monocytic leukemia in remission) is for purely monocytic leukemia.
- •C92.01 (AML in remission) is a less specific alternative.
- •Z85.6 (personal history of leukemia) should not be used during active post-remission treatment.