C92.60 ICD-10-CM Code: Acute myeloid leukemia with 11q23-abnormality not having achieved remission
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FY 2026 Apr update / Neoplasms (C00-D49) / Malignant neoplasms of lymphoid, hematopoietic and related tissue (C81-C96)
C92.60
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceAcute myeloid leukemia with 11q23-abnormality not having achieved remission
A specific type of acute myeloid leukemia with a chromosomal abnormality (11q23) that has not responded adequately to initial treatment.
Buddy Insight
Acute myeloid leukemia with 11q23-abnormality represents a cytogenetically defined AML subtype involving rearrangements of the KMT2A (MLL) gene at chromosome 11q23.
CMS-HCC V28
MappedHCC 17
RAF 4.209
CMS-HCC V24
MappedHCC 8
RAF 2.659
ACA/HHS
MappedHCC 8
Varies by metal level
ESRD/PACE
MappedHCC 8
RAF 0.353
RXHCC
MappedHCC 19
RAF 1.949
Code Book Path
Inclusion Terms
Official- Acute myeloid leukemia with 11q23-abnormality with failed remission
- Acute myeloid leukemia with 11q23-abnormality NOS
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for C92.60 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for C92.60 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for C92.60 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for C92.60 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for C92.60 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for C92.60 in this effective period.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →
Is C92.60 an HCC code?
Yes. C92.60 (Acute myeloid leukemia with 11q23-abnormality not having achieved remission) maps to Cancer Metastatic to Lung, Liver, Brain, and Other Organs; Acute Myeloid Leukemia Except Promyelocytic under the CMS-HCC V28 risk adjustment model (and Metastatic Cancer and Acute Leukemia under V24), with a community non-dual aged RAF of 4.209. It is billable for payment year 2026.
Coder answer: C92.60 is billable and maps to V28 HCC 17, Cancer Metastatic to Lung, Liver, Brain, and Other Organs; Acute Myeloid Leukemia Except Promyelocytic. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.
- Code
- C92.60
- Description
- Acute myeloid leukemia with 11q23-abnormality not having achieved remission
- HCC (V28)
- HCC 17 — Cancer Metastatic to Lung, Liver, Brain, and Other Organs; Acute Myeloid Leukemia Except Promyelocytic
- RAF
- 4.209
- Billable
- Yes
- Payment year
- 2026
HCC Category Mapping
Each model's RAF is its CMS base weight for that model's standard population, so weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. 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.
Work C92.60 in the Code Book — tabular path, V28 RAF, and MEAT checklist →
MEAT Criteria for C92.60
For C92.60 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 C92.60 during that encounter, not just copy-forwarded from a problem list.
Coder workflow notes
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What This Code Means
C92.60 is the ICD-10-CM diagnosis code for acute myeloid leukemia with 11q23-abnormality not having achieved remission. A specific type of acute myeloid leukemia with a chromosomal abnormality (11q23) that has not responded adequately to initial treatment. C92.60 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, C92.60 maps to Cancer Metastatic to Lung, Liver, Brain, and Other Organs; Acute Myeloid Leukemia Except Promyelocytic (HCC 17) with a community, non-dual, aged base RAF weight of 4.209. Under the older CMS-HCC V24 model, C92.60 maps to Metastatic Cancer and Acute Leukemia (HCC 8) with a community, non-dual, aged base RAF weight of 2.659. 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.
The 11q23-abnormality is a cytogenetic finding that should be documented in the pathology report. Because C92.60 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 C92.60 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •The 11q23-abnormality is a cytogenetic finding that should be documented in the pathology report
- •This code indicates the patient has not achieved remission status after treatment attempts
Clinical Significance
Acute myeloid leukemia with 11q23-abnormality represents a cytogenetically defined AML subtype involving rearrangements of the KMT2A (MLL) gene at chromosome 11q23. This abnormality is found in approximately 5-10% of adult AML cases and is associated with monocytic differentiation, extramedullary disease, and intermediate-to-poor prognosis depending on the specific fusion partner. The 'not in remission' designation indicates active disease not responding to treatment.
Documentation Requirements
- ✓Documentation must confirm the 11q23/KMT2A rearrangement by cytogenetics or FISH, specifying the fusion partner gene when identified (common partners include MLLT3/AF9, MLLT1/ENL, MLLT4/AF6).
- ✓Active disease status, blast percentage, and monocytic component should be documented.
- ✓Treatment response assessment and current therapeutic plan must be recorded.
- ✓Additional molecular mutations (FLT3, NPM1) should be documented when tested.
Commonly Confused Codes
- •C92.00 (acute myeloblastic leukemia, not in remission) is less specific and does not capture the 11q23 abnormality.
- •C92.50 (acute myelomonocytic leukemia) may overlap clinically due to monocytic features.
- •C92.40 (acute promyelocytic leukemia) has a different cytogenetic abnormality.
- •C92.A0 (AML with multilineage dysplasia) is a different morphologic subtype.
- •C91.00 (ALL with 11q23) may occur in infants/children and should not be confused.