D47.Z2
BillableCastleman disease
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is D47.Z2 an HCC code?
Yes. D47.Z2 maps to Breast, Prostate, Colorectal and Other Cancers and Tumors under the CMS-HCC V28 risk adjustment model (and Coagulation Defects and Other Specified Hematological Disorders under V24).
HCC Category Mapping
RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. 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.
MEAT Criteria for D47.Z2
For D47.Z2 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 D47.Z2 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
D47.Z2 is the ICD-10-CM diagnosis code for castleman disease. An abnormal growth of lymphoid tissue characterized by enlarged lymph nodes and excessive antibody production, with uncertain malignant potential. D47.Z2 sits in the ICD-10-CM chapter for neoplasms (c00-d49), within the section covering neoplasms of uncertain behavior, polycythemia vera and myelodysplastic syndromes (d37-d48).
Under the CMS-HCC V28 risk adjustment model, D47.Z2 maps to Breast, Prostate, Colorectal and Other Cancers and Tumors (HCC 21) with a community, non-dual, aged base RAF weight of 0.545. Under the older CMS-HCC V24 model, D47.Z2 maps to Coagulation Defects and Other Specified Hematological Disorders (HCC 48) with a community, non-dual, aged base RAF weight of 0.209. 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.
Ensure pathology confirms Castleman disease diagnosis; distinguish between unicentric and multicentric variants in documentation. Because D47.Z2 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 D47.Z2 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Ensure pathology confirms Castleman disease diagnosis; distinguish between unicentric and multicentric variants in documentation
- •Document any associated symptoms like fever, anemia, or elevated inflammatory markers
Clinical Significance
Castleman disease (also known as angiofollicular lymph node hyperplasia) is a rare lymphoproliferative disorder characterized by abnormal lymph node enlargement with characteristic histopathology. Unicentric disease involves a single lymph node region and is often curable with surgical resection, while multicentric Castleman disease is a systemic inflammatory condition with significant morbidity driven by interleukin-6 dysregulation.
Documentation Requirements
- ✓Documentation must include tissue biopsy confirming Castleman disease histology (hyaline vascular, plasma cell, or mixed type).
- ✓Specify unicentric versus multicentric disease.
- ✓For multicentric disease, document systemic symptoms (fever, night sweats, weight loss), laboratory findings (elevated interleukin-6, C-reactive protein, anemia), and human herpesvirus 8 status.
- ✓Treatment regimen (siltuximab, rituximab) should be documented.
Excludes 2 — Not included here, may code separately
- Kaposi's sarcoma (C46.-)
Code Also
- , if applicable, human herpesvirus 8 infection (B10.89)