C93.Z0 ICD-10-CM Code: Other monocytic leukemia, not having achieved remission
C93.Z0 maps to CMS-HCC V28 20 (RAF 1.136). Documentation must support MEAT. MEAT criteria · RAF calculator · free HCC coding tools
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FY 2026 Apr update / Neoplasms (C00-D49) / Malignant neoplasms of lymphoid, hematopoietic and related tissue (C81-C96)
C93.Z0
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceOther monocytic leukemia, not having achieved remission
This code describes a type of blood cancer called monocytic leukemia (cancer of monocyte white blood cells) that does not fit into other specific categories and has not gone into remission. The patient's cancer is still active and progressing despite treatment efforts.
Buddy Insight
Other monocytic leukemia, not having achieved remission, captures rare monocytic leukemia variants that do not fit standard acute, chronic, or juvenile classifications.
CMS-HCC V28
MappedHCC 20
RAF 1.136
CMS-HCC V24
MappedHCC 9
RAF 1.024
ACA/HHS
MappedHCC 9
Varies by metal level
ESRD/PACE
MappedHCC 9
RAF 0.181
RXHCC
MappedHCC 19
RAF 1.949
Code Book Path
Inclusion Terms
Official- Other monocytic leukemia NOS
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for C93.Z0 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for C93.Z0 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for C93.Z0 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for C93.Z0 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for C93.Z0 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for C93.Z0 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 C93.Z0 an HCC code?
Yes. C93.Z0 (Other monocytic leukemia, not having achieved remission) maps to Lung and Other Severe Cancers under the CMS-HCC V28 risk adjustment model (and Lung and Other Severe Cancers under V24), with a community non-dual aged RAF of 1.136. It is billable for payment year 2026.
Coder answer: C93.Z0 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.Z0
- Description
- Other monocytic leukemia, not having achieved remission
- HCC (V28)
- HCC 20 — Lung and Other Severe Cancers
- RAF
- 1.136
- 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 C93.Z0 in the Code Book — tabular path, V28 RAF, and MEAT checklist →
MEAT Criteria for C93.Z0
For C93.Z0 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 C93.Z0 during that encounter, not just copy-forwarded from a problem list.
Coder workflow notes
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What This Code Means
C93.Z0 is the ICD-10-CM diagnosis code for other monocytic leukemia, not having achieved remission. This code describes a type of blood cancer called monocytic leukemia (cancer of monocyte white blood cells) that does not fit into other specific categories and has not gone into remission. The patient's cancer is still active and progressing despite treatment efforts. C93.Z0 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.Z0 maps to Lung and Other Severe Cancers (HCC 20) with a community, non-dual, aged base RAF weight of 1.136. Under the older V24 model, C93.Z0 mapped to the same category but with a base RAF weight of 1.024, 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.
Verify the remission status in the medical record before coding - this code specifically indicates the leukemia has NOT achieved remission, so documentation must confirm active disease. Because C93.Z0 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 C93.Z0 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify the remission status in the medical record before coding - this code specifically indicates the leukemia has NOT achieved remission, so documentation must confirm active disease
- •The 'Z' in the code indicates 'other' monocytic leukemia; ensure more specific monocytic leukemia subtypes (like acute or chronic) are not documented, as those would use different code prefixes (C93.0-C93.9)
Clinical Significance
Other monocytic leukemia, not having achieved remission, captures rare monocytic leukemia variants that do not fit standard acute, chronic, or juvenile classifications. These uncommon subtypes may include morphologic or genetic variants that defy typical categorization and often require specialized tertiary center management.
Documentation Requirements
- ✓Documentation should describe the specific features of the monocytic leukemia that distinguish it from standard subtypes, supported by pathology, flow cytometry, or molecular findings.
- ✓The treatment history and confirmation that remission has not been achieved must be recorded.