C93.92 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 lookupC93.92

Effective periodFY2026 Apr Update (Apr 1-Sep 30)

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

C93.92

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

Monocytic leukemia, unspecified in relapse

A blood cancer affecting monocytes (a type of white blood cell) where the specific type is not identified and the cancer has returned after remission.

Buddy Insight

Monocytic leukemia, unspecified, in relapse indicates that an unclassified monocytic leukemia has returned after documented remission.

Overview Risk Models Code Book Documentation Audit Notes Edition comparison

CMS-HCC V28

Mapped

HCC 20

Lung and Other Severe Cancers

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

CMS-HCC V24

Historical

Not used for standard CY2026 Medicare Advantage payment. Select a historical period to review V24.

Not used for CY2026 payment

ACA/HHS

Mapped

HCC 009

HHS-HCC 009 adult, RAF varies...

Code-level coefficient reference

ESRD/PACE

Mapped

HCC 9

Lung and Other Severe Cancers

Code-level coefficient reference

RXHCC

Mapped

HCC 19

Leukemias and Other Hematolog...

Code-level coefficient reference

Code Book Path

Official

C93Monocytic leukemia C93.9Monocytic leukemia, unspecified C93.92Monocytic leukemia, unspecified in relapse

Inclusion Terms

Official

No inclusion terms are included in this display for C93.92. 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

C93.90Monocytic leukemia, unspecified, not having achieved remission C93.91Monocytic leukemia, unspecified 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 C93.92. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for C93.92. Check the code and parent instructions in the Code Book.

Code Also

Official

No Code Also instructions are included in this display for C93.92. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance

Documentation must establish prior remission followed by disease recurrence, including evidence of monocytic lineage involvement.

The provider should be queried to specify the monocytic leukemia subtype to guide appropriate salvage therapy selection.

Current disease status and treatment plan must be recorded.

MEAT Support

HCC Buddy guidance

Documentation must establish prior remission followed by disease recurrence, including evidence of monocytic lineage involvement.

The provider should be queried to specify the monocytic leukemia subtype to guide appropriate salvage therapy selection.

Current disease status and treatment plan must be recorded.

Audit Caution

HCC Buddy guidance

Relapse requires documented prior remission

do not code relapse if the patient never achieved remission. Query the provider to specify the monocytic leukemia subtype, as treatment for relapsed disease varies significantly by subtype. This unspecified code may trigger audit review.

Common Mistakes

HCC Buddy guidance

C93.02 (acute monoblastic/monocytic, in relapse), C93.12 (chronic myelomonocytic, in relapse), and C93.32 (juvenile myelomonocytic, in relapse) are all more specific alternatives.

C93.90 (not achieved remission) applies to primary treatment failure, not relapse.

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 C93.92 an HCC code?

Yes. C93.92 (Monocytic leukemia, unspecified 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: C93.92 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: C93.92
Description: Monocytic leukemia, unspecified 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

ESRDHCC 9, Lung and Other Severe Cancers

Not separately weighted

RxHCCHCC 19, Leukemias and Other Hematologic Cancers

Not separately weighted

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 C93.92 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for C93.92

For C93.92, 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

C93.92 is the ICD-10-CM diagnosis code for monocytic leukemia, unspecified in relapse. A blood cancer affecting monocytes (a type of white blood cell) where the specific type is not identified and the cancer has returned after remission. C93.92 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, C93.92 maps to Lung and Other Severe Cancers (HCC 20) with a source-labeled community, non-dual, aged reference coefficient of 1.136. 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.

This code requires documentation of prior remission followed by relapse; verify both statuses in medical record. For C93.92, 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 C93.92 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•This code requires documentation of prior remission followed by relapse; verify both statuses in medical record
•Do not use if this is the initial presentation without prior remission

Clinical Significance

Monocytic leukemia, unspecified, in relapse indicates that an unclassified monocytic leukemia has returned after documented remission. Relapsed disease of an unspecified subtype presents additional challenges because treatment options depend heavily on the specific leukemia type.

Documentation Requirements

✓Documentation must establish prior remission followed by disease recurrence, including evidence of monocytic lineage involvement.
✓The provider should be queried to specify the monocytic leukemia subtype to guide appropriate salvage therapy selection.
✓Current disease status and treatment plan must be recorded.

Commonly Confused Codes

•C93.02 (acute monoblastic/monocytic, in relapse), C93.12 (chronic myelomonocytic, in relapse), and C93.32 (juvenile myelomonocytic, in relapse) are all more specific alternatives.
•C93.90 (not achieved remission) applies to primary treatment failure, not relapse.