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C93.32 ICD-10-CM Code: Juvenile myelomonocytic leukemia, in relapse

C93.32 maps to CMS-HCC V28 20. A source-labeled RAF reference is available. Confirm the documented diagnosis and applicable coding requirements. MEAT criteria · RAF Calculator · HCC coding software

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Code lookupC93.32

FY 2026 Apr update / Neoplasms (C00-D49) / Malignant neoplasms of lymphoid, hematopoietic and related tissue (C81-C96)

C93.32

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Juvenile myelomonocytic leukemia, in relapse

A rare type of blood cancer in children called juvenile myelomonocytic leukemia that has returned after a period of remission.

Buddy the Bee presenting code insight

Buddy Insight

Juvenile myelomonocytic leukemia in relapse indicates disease recurrence after prior remission, often post-transplant.

OverviewRisk ModelsCode BookDocumentationAuditNotesEdition comparison

CMS-HCC V28

HCC 20

Coefficient HCC 20: 1.136 (Community Non-Dual Aged (CNA))

CMS-HCC V24

Historical

Historical

Not used for CY2026 payment

ACA/HHS

Context needed

HCC 009

Coefficient needs member context

ESRD/PACE

Context needed

HCC 9

Coefficient needs member context

RXHCC

Context needed

HCC 19

Coefficient needs member context

Code Book Path

Official
C93Monocytic leukemiaC93.3Juvenile myelomonocytic leukemiaC93.32Juvenile myelomonocytic leukemia, in relapse

Inclusion Terms

Official

No inclusion terms are included in this display for C93.32. Check the code and parent instructions in the Code Book.

Excludes 2

Official
  • Kaposi's sarcoma of lymph nodes (C46.3)Inherited from C81-C96
  • secondary and unspecified neoplasm of lymph nodes (C77.-)Inherited from C81-C96
  • secondary neoplasm of bone marrow (C79.52)Inherited from C81-C96
  • secondary neoplasm of spleen (C78.89)Inherited from C81-C96

Related Codes

Official
C93.30Juvenile myelomonocytic leukemia, not having achieved remissionC93.31Juvenile myelomonocytic leukemia, in remission

Includes

Official
  • monocytoid leukemiaInherited from C93

Excludes 1

Official
  • personal history of leukemia (Z85.6)Inherited from C93

Code First

Official

No Code First sequencing instructions are included in this display for C93.32. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for C93.32. Check the code and parent instructions in the Code Book.

Code Also

Official

No Code Also instructions are included in this display for C93.32. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance
Documentation must establish prior remission (usually post-transplant) followed by recurrence, with evidence such as rising monocyte counts, loss of donor chimerism, reappearance of the original clonal markers, or increasing splenomegaly.
Current treatment plan and response should be detailed.

MEAT Support

HCC Buddy guidance
Documentation must establish prior remission (usually post-transplant) followed by recurrence, with evidence such as rising monocyte counts, loss of donor chimerism, reappearance of the original clonal markers, or increasing splenomegaly.
Current treatment plan and response should be detailed.

Audit Caution

HCC Buddy guidance
Verify that the patient was genuinely in remission before coding relapse; progressive disease that never achieved remission is coded as C93.
If juvenile myelomonocytic leukemia has transformed to acute myeloid leukemia at relapse, the acute leukemia code takes precedence.

Common Mistakes

HCC Buddy guidance
C93.30 (not achieved remission) applies to initial treatment failure rather than relapse.
C93.31 (in remission) is the pre-relapse state.
C93.02 (acute monoblastic leukemia in relapse) should be considered if the juvenile myelomonocytic leukemia has transformed to acute leukemia.

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 C93.32 an HCC code?

Yes. C93.32 (Juvenile myelomonocytic leukemia, in relapse) maps to HCC 20, Lung and Other Severe Cancers under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 1.136. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes. It is billable for payment year 2026.

Coder answer: C93.32 is billable and maps to V28 HCC 20, Lung and Other Severe Cancers. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code
C93.32
Description
Juvenile myelomonocytic leukemia, in relapse
HCC (V28)
HCC 20 — Lung and Other Severe Cancers
RAF reference coefficient
1.136
Billable
Yes
Payment year
2026

HCC Category Mapping

V28HCC 20, Lung and Other Severe Cancers
1.136

These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. 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 context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.

Work C93.32 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for C93.32

For C93.32, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.

  • 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

Coder workflow notes

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What This Code Means

C93.32 is the ICD-10-CM diagnosis code for juvenile myelomonocytic leukemia, in relapse. A rare type of blood cancer in children called juvenile myelomonocytic leukemia that has returned after a period of remission. C93.32 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, C93.32 maps to Lung and Other Severe Cancers (HCC 20) with a source-labeled community, non-dual, aged reference coefficient of 1.136. No V24 mapping is shown for C93.32; use the applicable model and payment year when reviewing the V28 mapping. For CY2026 non-PACE Medicare Advantage, CMS uses 100% of the 2024 CMS-HCC model (V28). PACE uses a separate model blend. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes.

Relapse indicates the cancer has returned after previously being in remission; ensure documentation clearly states relapse. For C93.32, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule. 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, source-labeled coefficient references, and MEAT documentation criteria for C93.32 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • •Relapse indicates the cancer has returned after previously being in remission; ensure documentation clearly states relapse
  • •Do not confuse relapse with initial failure to achieve remission; relapse requires prior remission documentation

Clinical Significance

Juvenile myelomonocytic leukemia in relapse indicates disease recurrence after prior remission, often post-transplant. Relapsed juvenile myelomonocytic leukemia carries a particularly poor prognosis, with limited effective salvage options, and second transplantation may be considered based on individual patient factors.

Documentation Requirements

  • ✓Documentation must establish prior remission (usually post-transplant) followed by recurrence, with evidence such as rising monocyte counts, loss of donor chimerism, reappearance of the original clonal markers, or increasing splenomegaly.
  • ✓Current treatment plan and response should be detailed.

Commonly Confused Codes

  • •C93.30 (not achieved remission) applies to initial treatment failure rather than relapse.
  • •C93.31 (in remission) is the pre-relapse state.
  • •C93.02 (acute monoblastic leukemia in relapse) should be considered if the juvenile myelomonocytic leukemia has transformed to acute leukemia.

Child Codes

C93.30Juvenile myelomonocytic leukemia, not having achieved remission
HCC 20
C93.31Juvenile myelomonocytic leukemia, in remission
HCC 20
C93.32Juvenile myelomonocytic leukemia, in relapse
HCC 20

Code Hierarchy

└C93Monocytic leukemia└C93.3Juvenile myelomonocytic leukemia└C93.32Juvenile myelomonocytic leukemia, in relapse
└C93.32Juvenile myelomonocytic leukemia, in relapse

Also searched as

  • C93 32
  • C9332

For C93.32, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.

C93.32 maps to CMS-HCC V28 category 20, Lung and Other Severe Cancers. See the ICD-10 to HCC mapping hub for how the V28 crosswalk works. The mapping identifies a payment HCC category for C93.32. Review its source-labeled HCC coefficient above, check the RAF Calculator with complete member context for CMS-HCC V28 PY2026, and confirm the documentation the chart needs before the code is submitted. HCC Buddy shows no RAF score unless every required source and calculation check passes.

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