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C94.01 ICD-10-CM Code: Acute erythroid leukemia, in remission

C94.01 maps to CMS-HCC V28 17. 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 lookupC94.01

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

C94.01

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

Acute erythroid leukemia, in remission

A rare type of blood cancer where cancer cells develop from red blood cell precursors and the cancer has responded to treatment.

Buddy the Bee presenting code insight

Buddy Insight

Acute erythroid leukemia in remission indicates this rare erythroid-lineage leukemia has responded to intensive chemotherapy.

OverviewRisk ModelsCode BookDocumentationAuditNotesEdition comparison

CMS-HCC V28

HCC 17

Code-level coefficient reference

CMS-HCC V24

Historical

Historical

Not used for CY2026 payment

ACA/HHS

HCC 008

Code-level coefficient reference

ESRD/PACE

HCC 8

Code-level coefficient reference

RXHCC

HCC 19

Code-level coefficient reference

Code Book Path

Official
C94Other leukemias of specified cell typeC94.0Acute erythroid leukemiaC94.01Acute erythroid leukemia, in remission

Inclusion Terms

Official
  • Acute myeloid leukemia M6(a)(b)Inherited from C94.0
  • ErythroleukemiaInherited from C94.0

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
C94.00Acute erythroid leukemia, not having achieved remissionC94.02Acute erythroid leukemia, in relapse

Includes

Official

No Includes notes are included in this display for C94.01. Check the code and parent instructions in the Code Book.

Excludes 1

Official
  • leukemic reticuloendotheliosis (C91.4-)Inherited from C94
  • myelodysplastic syndromes (D46.-)Inherited from C94
  • personal history of leukemia (Z85.6)Inherited from C94
  • plasma cell leukemia (C90.1-)Inherited from C94

Code First

Official

No Code First sequencing instructions are included in this display for C94.01. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for C94.01. Check the code and parent instructions in the Code Book.

Code Also

Official

No Code Also instructions are included in this display for C94.01. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance
Documentation must explicitly confirm remission, supported by bone marrow biopsy showing less than 5% blasts and normalized erythropoiesis.
The specific remission criteria met (complete vs.
partial), date of remission, and ongoing surveillance or consolidation therapy plan must be recorded.

MEAT Support

HCC Buddy guidance
Documentation must explicitly confirm remission, supported by bone marrow biopsy showing less than 5% blasts and normalized erythropoiesis.
The specific remission criteria met (complete vs.
partial), date of remission, and ongoing surveillance or consolidation therapy plan must be recorded.

Audit Caution

HCC Buddy guidance
Remission from erythroid leukemia must be confirmed by bone marrow, not just by peripheral blood improvement.
Continue active leukemia coding throughout consolidation and surveillance phases.
Do not assume remission from normalized hemoglobin levels alone.

Common Mistakes

HCC Buddy guidance
C94.00 (not achieved remission) and C94.02 (in relapse) differ by treatment response.
D64.9 (anemia, unspecified) should not be used to describe residual anemia during remission from erythroid leukemia.
Z85.6 (personal history of leukemia) is premature during active surveillance.

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 C94.01 an HCC code?

Yes. C94.01 (Acute erythroid leukemia, in remission) maps to HCC 17, Cancer Metastatic to Lung, Liver, Brain, and Other Organs; Acute Myeloid Leukemia Except Promyelocytic under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 4.209. 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: C94.01 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
C94.01
Description
Acute erythroid leukemia, in remission
HCC (V28)
HCC 17 — Cancer Metastatic to Lung, Liver, Brain, and Other Organs; Acute Myeloid Leukemia Except Promyelocytic
RAF reference coefficient
4.209
Billable
Yes
Payment year
2026

HCC Category Mapping

V28HCC 17, Cancer Metastatic to Lung, Liver, Brain, and Other Organs; Acute Myeloid Leukemia Except Promyelocytic
4.209
ESRDHCC 8, Metastatic Cancer and Acute Leukemia
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 C94.01 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for C94.01

For C94.01, 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

C94.01 is the ICD-10-CM diagnosis code for acute erythroid leukemia, in remission. A rare type of blood cancer where cancer cells develop from red blood cell precursors and the cancer has responded to treatment. C94.01 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, C94.01 maps to Cancer Metastatic to Lung, Liver, Brain, and Other Organs; Acute Myeloid Leukemia Except Promyelocytic (HCC 17) with a source-labeled community, non-dual, aged reference coefficient of 4.209. No V24 mapping is shown for C94.01; 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.

Confirm pathology diagnosis of acute erythroid leukemia; this is a rare subtype requiring specific identification. For C94.01, 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 C94.01 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • •Confirm pathology diagnosis of acute erythroid leukemia; this is a rare subtype requiring specific identification
  • •The fifth character '1' indicates remission; document the remission status clearly in the medical record

Clinical Significance

Acute erythroid leukemia in remission indicates this rare erythroid-lineage leukemia has responded to intensive chemotherapy. Given the rarity and aggressive nature of this subtype, achieving remission often requires combination chemotherapy similar to other acute myeloid leukemia protocols, and long-term survival remains guarded.

Documentation Requirements

  • ✓Documentation must explicitly confirm remission, supported by bone marrow biopsy showing less than 5% blasts and normalized erythropoiesis.
  • ✓The specific remission criteria met (complete vs.
  • ✓partial), date of remission, and ongoing surveillance or consolidation therapy plan must be recorded.

Commonly Confused Codes

  • •C94.00 (not achieved remission) and C94.02 (in relapse) differ by treatment response.
  • •D64.9 (anemia, unspecified) should not be used to describe residual anemia during remission from erythroid leukemia.
  • •Z85.6 (personal history of leukemia) is premature during active surveillance.

Child Codes

C94.00Acute erythroid leukemia, not having achieved remission
HCC 17
C94.01Acute erythroid leukemia, in remission
HCC 17
C94.02Acute erythroid leukemia, in relapse
HCC 17

Code Hierarchy

└C94Other leukemias of specified cell type└C94.0Acute erythroid leukemia└C94.01Acute erythroid leukemia, in remission
└C94.01Acute erythroid leukemia, in remission

For C94.01, 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.

C94.01 maps to CMS-HCC V28 category 17, Cancer Metastatic to Lung, Liver, Brain, and Other Organs; Acute Myeloid Leukemia Except Promyelocytic. See the ICD-10 to HCC mapping hub for how the V28 crosswalk works. The mapping identifies a payment HCC category for C94.01. 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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Open C94.01 in the Code Book for the full Index-to-Tabular path, MEAT checklist, and V28 HCC mapping, or in the Encoder to code from a keyword search. Pro includes 7 days to try everything, no card required.

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