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C92.A0

Billable

Acute myeloid leukemia with multilineage dysplasia, 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.A0 an HCC code?

Yes. C92.A0 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

V28HCC 17Metastatic Cancer and Acute Leukemia
0.368
V24HCC 8Metastatic Cancer and Acute Leukemia
2.484
ESRDHCC 8Metastatic Cancer and Acute Leukemia
0.000
RxHCCHCC 19Lymphoma and Other Cancers
0.000

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.A0

For C92.A0 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.A0 during that encounter — not just copy-forwarded from a problem list.

What This Code Means

C92.A0 is the ICD-10-CM diagnosis code for acute myeloid leukemia with multilineage dysplasia, not having achieved remission. A type of acute myeloid leukemia where multiple cell lines show abnormal development and the cancer has not responded adequately to initial treatment. C92.A0 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.A0 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.A0 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.

Multilineage dysplasia is a morphologic finding that should be documented in the pathology report. Because C92.A0 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.A0 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Multilineage dysplasia is a morphologic finding that should be documented in the pathology report
  • Confirm this is not a myelodysplastic syndrome but rather acute myeloid leukemia with dysplastic features

Clinical Significance

Acute myeloid leukemia with multilineage dysplasia (AML-MLD) is an AML subtype characterized by dysplastic changes in two or more myeloid cell lines (erythroid, granulocytic, megakaryocytic), often arising from prior myelodysplastic syndrome (MDS). AML-MLD typically occurs in older adults and carries an adverse prognosis compared to de novo AML without dysplasia. The 'not in remission' status indicates active disease requiring treatment.

Documentation Requirements

  • Documentation must confirm the presence of multilineage dysplasia (dysplasia in 50% or more of cells in at least two myeloid lineages) on bone marrow examination.
  • Prior history of MDS should be documented if present, as this supports the diagnosis.
  • Cytogenetic and molecular testing results, blast percentage, and MDS-related changes should be recorded.
  • Treatment response and current disease status must be explicitly stated.

Commonly Confused Codes

Code Hierarchy

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