C95.01 maps to CMS-HCC V28 18. A source-labeled RAF reference is available. Confirm the documented diagnosis and applicable coding requirements. MEAT criteria · RAF Calculator · free HCC coding tools

ICD-10-CM Code View

HCC Buddy Code Card

Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.

Code lookupC95.01

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)

C95.01

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

Acute leukemia of unspecified cell type, in remission

An acute leukemia of unknown cell type where the cancer has responded to treatment and is in remission.

Buddy Insight

Acute leukemia of unspecified cell type in remission indicates that an acute leukemia of undetermined lineage has responded to treatment.

Overview Risk Models Code Book Documentation Audit Notes Edition comparison

CMS-HCC V28

Mapped

HCC 18

Cancer Metastatic to Bone, Ot...

Coefficient HCC 18: 2.341 (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

Context needed

HCC 008, HCC 009

Conditional HHS-HCC mapping: HCC 008 when age >= 18; HCC 009 when age < 18. Select the member context before showing a coefficient reference. Metal level and model segment are required for coefficients; no single RAF is shown.

Coefficient needs member context

ESRD/PACE

Context needed

HCC 8

ESRD candidates: HCC 8 when age >= 18 or age < 18. ESRD mapping is separate from PACE. Dialysis, graft, age, and other member context determine the applicable coefficient.

Coefficient needs member context

RXHCC

Mapped

HCC 19

Leukemias and Other Hematolog...

Code-level coefficient reference

Code Book Path

Official

C95Leukemia of unspecified cell type C95.0Acute leukemia of unspecified cell type C95.01Acute leukemia of unspecified cell type, in remission

Inclusion Terms

Official

Acute bilineal leukemiaInherited from C95.0
Acute mixed lineage leukemiaInherited from C95.0
Biphenotypic acute leukemiaInherited from C95.0
Stem cell leukemia of unclear lineageInherited from C95.0

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

C95.00Acute leukemia of unspecified cell type not having achieved remission C95.02Acute leukemia of unspecified cell type, in relapse

Includes

Official

No Includes notes are included in this display for C95.01. Check the code and parent instructions in the Code Book.

Excludes 1

Official

personal history of leukemia (Z85.6)Inherited from C95, C95.0
acute exacerbation of unspecified chronic leukemia (C95.10)Inherited from C95, C95.0

Code First

Official

No Code First sequencing instructions are included in this display for C95.01. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for C95.01. Check the code and parent instructions in the Code Book.

Code Also

Official

No Code Also instructions are included in this display for C95.01. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance

Remission status must be explicitly documented with supporting bone marrow evidence showing blast count below 5% and recovery of normal hematopoiesis.

Documentation should address why the cell type remains unspecified and whether further classification attempts are planned.

Ongoing surveillance plan must be recorded.

MEAT Support

HCC Buddy guidance

Remission status must be explicitly documented with supporting bone marrow evidence showing blast count below 5% and recovery of normal hematopoiesis.

Documentation should address why the cell type remains unspecified and whether further classification attempts are planned.

Ongoing surveillance plan must be recorded.

Audit Caution

HCC Buddy guidance

Do not use unspecified codes when pathology data supporting a specific lineage is available.

Review the complete medical record for flow cytometry or molecular studies that may enable more specific coding.

Maintain active leukemia codes during consolidation and surveillance rather than switching to Z85.6.

Common Mistakes

HCC Buddy guidance

C91.01, C92.01, and C93.01 are used when specific cell lineage is known.

C95.11 (chronic leukemia of unspecified cell type, in remission) indicates chronic rather than acute disease.

Z85.6 (personal history of leukemia) should only be used after active treatment and surveillance are complete.

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 C95.01 an HCC code?

Yes. C95.01 (Acute leukemia of unspecified cell type, in remission) maps to HCC 18, Cancer Metastatic to Bone, Other and Unspecified Metastatic Cancer; Acute Leukemia Except Myeloid under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 2.341. 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: C95.01 is billable and maps to V28 HCC 18, Cancer Metastatic to Bone, Other and Unspecified Metastatic Cancer; Acute Leukemia Except Myeloid. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code: C95.01
Description: Acute leukemia of unspecified cell type, in remission
HCC (V28): HCC 18 — Cancer Metastatic to Bone, Other and Unspecified Metastatic Cancer; Acute Leukemia Except Myeloid
RAF reference coefficient: 2.341
Billable: Yes
Payment year: 2026

HCC Category Mapping

V28HCC 18, Cancer Metastatic to Bone, Other and Unspecified Metastatic Cancer; Acute Leukemia Except Myeloid

2.341

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 C95.01 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for C95.01

For C95.01, 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

Get the V28 mapping + MEAT cheat sheet

One printable reference: check representative V28 mappings and the documentation reminders your note needs. Free, no card.

Free PDF. No card. Unsubscribe anytime.

What This Code Means

C95.01 is the ICD-10-CM diagnosis code for acute leukemia of unspecified cell type, in remission. An acute leukemia of unknown cell type where the cancer has responded to treatment and is in remission. C95.01 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, C95.01 maps to Cancer Metastatic to Bone, Other and Unspecified Metastatic Cancer; Acute Leukemia Except Myeloid (HCC 18) with a source-labeled community, non-dual, aged reference coefficient of 2.341. 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.

Use C95.01 when the provider wording supports acute leukemia of unspecified cell type, in remission. Check the FY2026 tabular notes and the full code path before the final code choice. For C95.01, 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 C95.01 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Use C95.01 when the provider wording supports acute leukemia of unspecified cell type, in remission. Check the FY2026 tabular notes and the full code path before the final code choice.
•For this DOS, capture the provider's current assessment and the care action documented for acute leukemia of unspecified cell type, in remission. Keep the checklist tied to the note.
•Do not swap C95.01 with C95.00. The FY2026 tabular describes C95.00 as acute leukemia of unspecified cell type not having achieved remission. Follow the documented detail.
•C95.01 maps to V28 HCC 18, Cancer Metastatic to Bone, Other and Unspecified Metastatic Cancer; Acute Leukemia Except Myeloid. The mapping does not replace the documentation review. The code still has to match the note.
•Ask Buddy to show the official notes for C95.01 or compare its code path with C95.00.

Clinical Significance

Acute leukemia of unspecified cell type in remission indicates that an acute leukemia of undetermined lineage has responded to treatment. If the cell type was never definitively characterized even after complete workup, this code remains appropriate, though it is more commonly a transitional code used while awaiting final pathologic classification.

Documentation Requirements

✓Remission status must be explicitly documented with supporting bone marrow evidence showing blast count below 5% and recovery of normal hematopoiesis.
✓Documentation should address why the cell type remains unspecified and whether further classification attempts are planned.
✓Ongoing surveillance plan must be recorded.

Commonly Confused Codes

•C91.01, C92.01, and C93.01 are used when specific cell lineage is known.
•C95.11 (chronic leukemia of unspecified cell type, in remission) indicates chronic rather than acute disease.
•Z85.6 (personal history of leukemia) should only be used after active treatment and surveillance are complete.