ICD-10-CM: The Hematopoietic Codes

ICD-10-CM: 2/21/2012
The 1

Hematopoietic
Codes

ICD-10-CM Implementation Team
for Cancer Registrars
Presenters:

Jennifer Ruhl, RHIT, CCS, CTR (NCI/SEER)
Jim Hofferkamp, CTR (NAACCR)
February 22, 2012

Overview of Presentation

 Introduction
 ICD-9-CM Categories
 ICD-10-CM Categories/ Subcategories
 Review of Coding Systems (by WHO

category classification)
 Review of Hematopoietic coding

(based on Hematopoietic Rules and
Database)

Advantages of ICD-10-CM for
Hematopoietic coding

 More subcategories for
hematopoietic coding

 More specified histologies listed
as inclusion terms

 Makes it easier for medical coders
to determine best code

 More one to one conversions to
ICD-O-3 hematopoietic histologies

Organization of Code System 2/21/2012
2
 ICD-10-CM has 3 –7 characters, and are
not case sensitive
• Character 1 is alpha (all letters are used,
except U)
• Character 2 is numeric
• Characters 3 –7 are alpha or numeric

– I10 – Essential (primary) hypertension
– A69.20 – Lyme disease, unspecified

ICD-9-CM to ICD-10-CM

ICD-9-CM Categories Subcategories
Example 11 66
ICD-10-CM 203
Example 17 203.0
C90 113
C90.0

ICD-O-3 and ICD-10-CM

 C42.1 does not exist in ICD-10-CM
 C77 codes are for metastatic

lymph node involvement, not for
lymphomas

ICD-9-CM Categories 2/21/2012
3
 Diffuse Non-Hodgkin’s lymphoma
 Hodgkin’s disease
 Other malignant neoplasm of

lymphoid and histiocytic tissue
 Multiple Myeloma and other

Immunoproliferative diseases

ICD-9-CM Categories

 Lymphoid Leukemia
 Myeloid Leukemia
 Monocytic Leukemia
 Other specified Leukemia
 Leukemia of unspecified cell type
 Polycythemia vera
 Myelodysplastic syndromes

ICD-10-CM CATEGORIES
THE LYMPHOMAS

Lymphomas: The 5th character 2/21/2012
4
0 – Unspecified site
1 – Lymph nodes of head, face, neck
2 – Intrathoracic lymph nodes
3 - Intra-abdominal lymph nodes
4 – Lymph nodes of axilla and upper

limb
5 – Lymph nodes of inguinal region

and lower limb

Lymphomas: The 5th character

6 – Intrapelvic nodes
7 – Spleen
8 – Lymph nodes of multiple sites
9 – Extranodal and solid organ sites

Note: Categories with a fifth character will
have a “_” after the number

ICD-10-CM Structure

 Diffuse large B-cell lymphoma
confined to the axillary lymph
nodes
C83.34

Axillary lymph nodes (5th character location)
Diffuse large B-cell lymphoma (subcategory)
Non-follicular lymphoma (category)

Lymphoma 5th character : ICD-10- 2/21/2012
CM compared to ICD-O-3 5

Description ICD-10-CM 5th ICD-O-3
character
Lymph nodes of head, face and neck 1 C77.0
Intrathoracic lymph nodes 2 C77.1
Intra-abdominal lymph nodes 3 C77.2
Lymph nodes of axilla or arm 4 C77.3
Lymph nodes of inguinal region or leg 5 C77.4
Pelvic lymph nodes 6 C77.5

Lymphoma 5th character: ICD-10-
CM compared to ICD-O-3

Description ICD-10-CM ICD-O-3
5th character
Lymph nodes of multiple regions
Lymph node, NOS 8 C77.8
Spleen
Unspecified site 0 C77.9
Specified organ
7 C42.2

0 C80.9

9 Primary
site

ICD-10-CM Categories

 Hodgkin disease

C81.0_ – Nodular lymphocyte predominant
C81.1_ – Nodular sclerosis
C81.2_ – Mixed cellularity
C81.3_ – Lymphocyte depleted
C81.4_ – Lymphocyte rich
C81.7_ – Other classical Hodgkin
C81.9_ – Unspecified

ICD-10-CM Categories 2/21/2012
6
 Follicular [Nodular] non-Hodgkin’s
lymphoma

C82.0_ – Grade I
C82.1_ – Grade II
C82.2_ – Grade III, unspecified
C82.3_ – Grade IIIa
C82.4_ – Grade IIIb
C82.5_ – Diffuse follicle center
C82.6_ – Cutaneous follicle center
C82.8_ – Other types of follicular
C82.9_ – Unspecified follicular

Coding Moment

 Patient presents with a enlarged
right cervical lymph node. A
biopsy is done and confirms grade
3 follicular lymphoma. Additional
staging work-up was negative for
any further disease.

• What would ICD-10-CM code would be
assigned to this case?

• What would we assign as ICD O 3 site
and histology?

Coding Moment

We would assign… Follicular lymphoma
 C82.2_
C82.0_ – Grade I
C82.1_ – Grade II
C82.2_ – Grade III, unspecified
C82.3_ – Grade IIIa
C82.4_ – Grade IIIb
C82.5_ – Diffuse follicle center
C82.6_ – Cutaneous follicle center
C82.8_ – Other types of follicular
C82.9_ – Unspecified follicular

Coding Moment 2/21/2012
7
The last character is…

1  0 – Unspecified site
The final ICD 10cm  1 – Lymph nodes of head, face, neck
code is…  2 – Intrathoracic lymph nodes

 C82.21  3 - Intra-abdominal lymph nodes
 4 – Lymph nodes of axilla and upper
The final ICD O 3 code
is… limb
 5 – Lymph nodes of inguinal region and
 C77.0
 9698/3 lower limb
 6 – Intrapelvic nodes
 7 – Spleen
 8 – Lymph nodes of multiple sites
 9 – Extranodal and solid organ sites

ICD-10-CM Categories

 Non-follicular lymphoma
C83.0_ – Small cell B-cell lymphoma

– Lymphoplasmacytic lymphoma
– Nodal marginal zone lymphoma
– Non-leukemic variant of B-CLL
– Splenic marginal zone lymphoma

C83.1_ – Mantle cell lymphoma

ICD-10-CM Categories

 Non-follicular lymphoma
C83.3_ – Diffuse large B-cell lymphoma

– Anaplastic diffuse large B-cell lymphoma
– CD30-positive diffuse large B-cell lymphoma
– Centroblastic diffuse large B-cell lymphoma
– Diffuse large B-cell lymphoma, subtype not specified
– Immunoblastic diffuse large B-cell lymphoma
– Plasmablastic diffuse large B-cell lymphoma
– Diffuse large B-cell lymphoma, subtype not specified
– T-cell rich diffuse large B-cell lymphoma

ICD-10-CM Categories 2/21/2012
8
 Non-follicular lymphoma
C83.5_ – Lymphoblastic (diffuse)

– B-precursor lymphoma
– Lymphoblastic B-cell lymphoma
– Lymphoblastic lymphoma NOS
– Lymphoblastic T-cell lymphoma
– T-precursor lymphoma

C83.7_ – Burkitt lymphoma

ICD-10-CM Categories

 Non-follicular lymphoma
C83.8_ – Other non-follicular lymphoma

– Intravascular large B-cell lymphoma
– Lymphoid granulomatosis
– Primary effusion B-cell lymphoma

C83.9_ – Non-follicular lymphoma
(diffuse), unspecified

ICD-10-CM Categories

 Mature T/NK-cell lymphomas
C84.0_ – Mycosis Fungoides
C84.1_ – Sezary’s disease
C84.4_ – Peripheral T-cell lymphoma,
not specified
C84.6_ – Anaplastic large cell
lymphoma, ALK positive
C84.7_ – Anaplastic large cell
lymphoma, ALK positive

ICD-10-CM Categories 2/21/2012
9
 Mature T/NK-cell lymphomas
C84.A_ – Cutaneous T-cell lymphoma,
unspecified
C84.Z_ – Other mature T/NK-cell
lymphomas
C84.9_ – Mature T/NK-cell lymphoma,
unspecified

ICD-10-CM Categories

 Other/unspecified B-cell lymphomas
C85.1_ – Unspecified B-cell lymphoma
C85.2_ – Mediastinal (thymic) large B-cell
lymphoma
C85.8_ – Other specified types of NHL
C85.9_ – NHL, unspecified

– Lymphoma, NOS
– Malignant lymphoma, NOS
– Non-Hodgkin lymphoma, NOS

ICD-10-CM Categories

 Other specified T/NK-cell lymphomas

C86.0 – Extranodal NK/T-cell lymphoma
C86.1 – Hepatosplenic T-cell lymphoma (9716/3)
C86.2 – Enteropathy-type (intestinal) T-cell

lymphoma
C86.3 – Subcutaneous panniculitis-like T-cell

lymphoma

ICD-10-CM Categories 2/21/2012
10
 Other specified T/NK-cell lymphomas

C86.4 – Blastic NK-cell lymphoma
C86.5 – Angioimmunoblastic T-cell lymphoma
C86.6 – Primary cutaneous CD30+ T-cell

proliferations

Note: no fifth character “location” code for C86

ICD-10-CM Categories

 Malignant immunoproliferative
diseases and certain other B-cell
lymphomas

C88.0 – Waldenstrom macroglobulinemia
C88.2 – Heavy chain disease
C88.3 – Immunoproliferative small intestinal

disease
C88.4 – Extranodal marginal zone lymphoma

(MALT)

ICD-10-CM Categories

 Malignant immunoproliferative
diseases and certain other B-cell
lymphomas

C88.8 – Other immunoproliferative diseases
C88.9 – Malignant immunoproliferative disease,

NOS

Note: no fifth character “location” code for C88

Leukemia & Immunoproliferative 2/21/2012
5th character 11

Description ICD-10-CM
5th
Not having achieved
remission/ failed remission character
In remission 0
In relapse
1
2

ICD-10-CM Categories

 Multiple myeloma and malignant
plasma cell neoplasms

C90.0_ Multiple myeloma
C90.1_ Plasma cell leukemia
C90.2_ Extramedullary plasmacytoma
C90.3_ Solitary plasmacytoma

Coding Moment

 A patient presents the ER with
severe back pain. While at your
facility he is diagnosed with
multiple myeloma. He is referred
to an oncologist and discharged.

• What would ICD-10-CM code would be
assigned to this case?

• What would we assign as ICD O 3 site
and histology?

Coding Moment 2/21/2012
12
We would assign… Multiple myeloma
 C90.0
• C90.0_ Multiple myeloma
• C90.1_ Plasma cell leukemia
• C90.2_ Extramedullary

plasmacytoma
• C90.3_ Solitary plasmacytoma

Coding Moment

The fifth Character
would be…
0
The ICD-10-CM code
would be…

 C90.00
The ICD O 3 code
would be…

 C42.1
 9732/3

ICD-10-CM Categories

 Lymphoid Leukemias

C91.0_ Acute lymphoblastic leukemia [ALL]
C91.1_ Chronic lymphocytic leukemia of B-cell

type
C91.3_ Prolymphocytic leukemia of B-cell type
C91.4_ Hairy Cell Leukemia
C91.5_ Adult T-cell lymphoma/leukemia (HTLV-

1-associated)

ICD-10-CM Categories 2/21/2012
13
 Lymphoid Leukemias

C91.6_ Prolymphocytic leukemia of T-cell type
C91.A_ Mature B-cell leukemia Burkitt-type
C91.Z_ Other lymphoid leukemia
C91.9_ Lymphoid leukemia, unspecified

Coding Moment

 Patient presents with a single
enlarged cervical lymph node and
is diagnosed chronic B-cell
lymphocytic leukemia without
remission. Imaging did not
indicate any additional disease.
Patient was referred to and
oncologist and discharged.

Coding Moment

 What would be the ICD-10-CM
code?

• C91.10

 What would be the ICD-O-3 code?

• If no further information is available,
code to C77.0 and 9670/3 per PH 10.

• This could change if we find additional
information

ICD-10-CM Categories 2/21/2012
14
 Myeloid Leukemias

C92.0_ Acute myeloblastic leukemia
C92.1_ Chronic myeloid leukemia, BCR/ABL-

positive
C92.2_ Atypical chronic myeloid leukemia,

BCR/ABL-negative
C92.3_ Myeloid Sarcoma
C92.4_ Acute promyelocytic leukemia

ICD-10-CM Categories

 Myeloid Leukemias

C92.5_ Acute myelomonocytic leukemia
C92.6_ Acute myeloid leukemia with 11q23-

abnormality
C92.A_ Acute myeloid leukemia with

multilineage dysplastic
C92.Z_ Other myeloid leukemia
C92.9_ Myeloid leukemia, unspecified

ICD-10-CM Categories

 Monocytic Leukemia

C93.0_ Acute monoblastic/monocytic leukemia
C93.1_ Chronic myelomonocytic leukemia
C93.3_ Juvenile myelomonocytic leukemia
C93.Z_ Other monocytic leukemia
C93.9_ Monocytic leukemia, unspecified

ICD-10-CM Categories 2/21/2012
15
 Other Leukemias of specified cell type

C94.0_ Acute erythroid leukemia
C94.2_ Acute megakarybolastic leukemia
C94.3_ Mast cell leukemia
C94.4_ Acute panmyelosis with myelofibrosis
C94.6_ Myelodysplastic disease, not classified

ICD-10-CM Categories

 Other Leukemias of specified cell type

C94.6_ Myelodysplastic disease, not classified

This is not to be confused with “myelodysplastic
disorder”

C94.8_ Other specified Leukemias

Aggressive NK-cell leukemia
Acute basophilic leukemia

ICD-10-CM Categories

 Leukemia of unspecified cell type

C95.0_ Acute leukemia of unspecified cell type

Acute leukemia, NOS
Biphenotypic acute leukemia

C95.1_ Chronic leukemia of unspecified cell type

– Chronic leukemia, NOS

C95.9_ Leukemia, unspecified

– Leukemia, NOS

ICD-10-CM Categories 2/21/2012
16
 Other and unspecified malignant
neoplasms of lymphoid, hematopoietic
and related tissue

C96.0 Multifocal and multisystemic
(disseminated) Langerhans-cell histiocytosis

– Histiocytosis X, multisystemic
– Letterer-Siwe disease

C96.2 Malignant mast cell tumor/mast cell
sarcoma

C96.4 Sarcoma of dendritic cells

– Follicular/ interdigitating/Langerhans cell sarcoma

ICD-10-CM Categories

 Other and unspecified malignant
neoplasms of lymphoid, hematopoietic
and related tissue

C96.5 Multifocal and unisystemic Langerhans-
cell histiocytosis

C96.6 Unifocal Langerhans-cell histiocytosis
C96.A Histiocytic sarcoma
C96.Z Other specified malignant neoplasms of

lymphoid, hematopoietic and related tissue
C96.9 Malignant neoplasm of lymphoid,

hematopoietic and related tissue, unspecified

ICD-10-CM Categories

 Other and unspecified malignant
neoplasms of lymphoid, hematopoietic
and related tissue

C96.5 Multifocal and unisystemic Langerhans-
cell histiocytosis

C96.6 Unifocal Langerhans-cell histiocytosis
C96.A Histiocytic sarcoma
C96.Z Other specified malignant neoplasms of

lymphoid, hematopoietic and related tissue
C96.9 Malignant neoplasm of lymphoid,

hematopoietic and related tissue, unspecified

ICD-10-CM Categories 2/21/2012
17
 Polycythemia Vera

D45: Polycythemia vera

ICD-10-CM Categories

 Myelodysplastic syndromes

D46.0 Refractory anemia without ring
sideroblasts, so stated

D46.1 Refractory anemia with ring sideroblasts
D46.20 Refractory anemia with excess of blasts,

unspecified (RAEB NOS)
D46.21 Refractory anemia with excess of blasts,

1 (RAEB 1)
D46.22 Refractory anemia with excess of blasts

2 (RAEB 2)

ICD-10-CM Categories

 Myelodysplastic syndromes

D46.A Refractory cytopenia with multilineage
dysplasia

D46.B Refractory cytopenia with multilineage
dysplasia and ring sideroblasts

D46.C Myelodysplastic syndrome with isolated
del (5q) chromosomal abnormality

D46.4 Refractory anemia, unspecified
D46.Z Other myelodysplastic syndromes
D46.9 Myelodysplastic syndrome, unspecified

Myelodysplasia NOS

ICD-10-CM Categories 2/21/2012
18
 Other neoplasms of uncertain behavior
of lymphoid, hematopoietic and related
tissue

D47.0 Histiocytic and mast cell tumors of
uncertain behavior

D47.1 Chronic myeloproliferative disease

– Chronic neutrophilic leukemia
– Myeloproliferative disease, unspecified

D47.2 Monoclonal gammopathy [MGUS]

ICD-10-CM Categories

 Other neoplasms of uncertain behavior
of lymphoid, hematopoietic and related
tissue

D47.3 Essential (hemorrhagic)
thrombocythemia

– Essential thrombocytosis
– Idiopathic hemorrhagic thrombocythemia

D47.4 Osteomyelofibrosis

– Chronic idiopathic myelofibrosis
– Myelofibrosis (idiopathic)(with myeloid metaplasia)
– Myelosclerosis (megakaryocytic) ( with myeloid

metaplasia)

ICD-10-CM Categories

 Other neoplasms of uncertain behavior
of lymphoid, hematopoietic and related
tissue

D47.Z1 Post-transplant lymphoproliferative
disorder (PTLD)

D47.Z9 Other specified neoplasms of uncertain
behavior of lymphoid, hematopoietic and
related tissues

D47.9 Neoplasm of uncertain behavior of
lymphoid, hematopoietic and related tissue,
unspecified

COMPARISON OF ICD-O-3 2/21/2012
HEMATOPOIETIC HISTOLOGIES (9590- 19
9992) TO ICD-9-CM, ICD-10 (CAUSE OF
DEATH CODING) AND ICD-10-CM

WHO CATEGORIES

Myeloproliferative Neoplasms
(Table B1)

ICD-O-3 Code and Histology ICD-9- ICD- ICD-
CM 10 10-CM
9740 Mast cell sarcoma
9741 Systemic mastocytosis 202.6_ C96.2 C96.2
9742 Mast cell leukemia 202.6_ C96.2 C96.2
9875 Chronic myelogenous 207.8_ C94.3 C94.3_
205.1_ C92.1 C92.1_
leukemia, BCR/ABL1 positive
9950 Polycythemia vera 238.4 D45 D45

Myeloproliferative Neoplasms
(Table B1)

ICD-O-3 Code and Histology ICD-9- ICD- ICD-
CM 10 10-CM

9960 Chronic myeloproliferative 238.79 D47.1 D47.1
disease, NOS 238.76
238.71 D47.1 D47.4
9961 Myelosclerosis with myeloid
metaplasia D47.3 D47.3
D47.1 D47.1
9962 Essential thrombocythemia C94.7 C94.8_

9963 Chronic neutrophilic leukemia 205.1_

9964 Chronic eosinophilic leukemia, 207.8_
NOS

Myeloid and lymphoid neoplasms 2/21/2012
with PDGFRA rearrangement 20
(Table B2)

ICD-O-3 Code and Histology ICD-9- ICD- ICD-
CM 10 10-CM
9965 Myeloid and lymphoid
neoplasms with PDGFRA 238.79 D47.7 D47.Z9
rearrangement
238.79 D47.7 D47.Z9
9966 Myeloid neoplasms with 238.79 D47.7 D47.Z9
PDGFRB rearrangement

9967 Myeloid and lymphoid
neoplasms with FGFR1
abnormalities

Myelodysplastic/ Myeloproliferative
Neoplasms (B3)

ICD-O-3 Code and Histology ICD-9- ICD- ICD-
CM 10 10-CM

9876 Atypical chronic myeloid 205.1_ C92.1 C92.2_

leukemia, BCR-ABL1 negative

9945 Chronic myelomonocytic 205.1_ C92.1 C93.1_

leukemia

9946 Juvenile myelomonocytic 205.1_ C92.1 C93.3_

leukemia

9975 Myelodysplastic/myeloprolifera 238.79 D47.7 C94.6_;

tive neoplasm unclassifiable D47.1

Myelodysplastic Syndromes
(Table B4)

ICD-O-3 Code and Histology ICD-9- ICD- ICD-
CM 10 10-CM

9980 Refractory anemia 238.72 D46.4 D46.4
D46.1 D46.1
9982 Refractory anemia with ring 238.72 D46.2
D46.7 D46.2_
sideroblasts D46.7
D46.A,
9983 Refractory anemia with excess 238.73 D46.B
D46.C
blasts

9985 Refractory cytopenia with 238.72

multilineage dysplasia

9986 Myelodysplastic syndrome 238.74

associated with isolated del

(5q)

Myelodysplastic Syndromes 2/21/2012
(Table B4) 21

ICD-O-3 Code and Histology ICD-9- ICD- ICD-
CM 10 10-CM

9987 Therapy-related 238.77 D47.7 D47.Z1
myelodysplastic syndrome,
NOS 238.75 D46.9 C94.6_;
D46.9,
9989 Myelodysplastic syndrome, D46.Z
unclassifiable
238.72 D46.0 D46.0
9991 Refractory neutropenia 238.72 D46.0 D46.0
9992 Refractory thrombocytopenia

Acute Myeloid Leukemia (AML)
and Related Precursors(Table B5)

ICD-O-3 Code and Histology ICD-9- ICD- ICD-
CM 10 10-CM

9727 Blastic plasmacytoid dendritic 202.9_ C96.7 C86.4,
cell neoplasm 207.0_ C94.0 C96.4
205.9_ C92.9 C94.0_
9840 Acute erythroid leukemia 205.0_ C92.0
9860 Myeloid leukemia, NOS 205.1_ C92.1 C92.9_;
C93.9_
9861 Acute myeloid leukemia, NOS 205.0_ C92.0 C92.0_
9863 Chronic myeloid leukemia,
C92.1_;
NOS C92.2_;
C92.9_
9865 Acute myeloid leukemia with C92.0_
t(6;9)(p23;q34);DEK-NUP214

Acute Myeloid Leukemia (AML)
and Related Precursors(Table B5)

ICD-O-3 Code and Histology ICD-9- ICD-10 ICD-10-
CM CM
9866 Acute promyelocytic leukemia
(AML with t(15;17)(q22;q12)) 205.0_ C92.4 C92.4_
PML/RARA
205.0_ C92.5 C92.5_
9867 Acute myelomonocytic leukemia 205.0_ C92.0 C92.0_

9869 Acute myeloid leukemia with 205.0_ C92.0 C94.8_
inv(3)(q21;q26.2) or 205.0_ C92.0 C92.0_
t(3;3)(q21;q26.2); RPN1-EVI1
205.0_ C92.0 C92.0_
9870 Acute basophilic leukemia

9871 Acute myeloid leukemia with
inv(16)(p13.1q22) or t(16;16)
(p13.1;q22), CBFB/MYH11

9872 Acute myeloid leukemia with
minimal differentiation

Acute Myeloid Leukemia (AML) 2/21/2012
and Related Precursors(Table B5) 22

ICD-O-3 Code and Histology ICD-9- ICD-10 ICD-10-
CM CM

9873 Acute myeloid leukemia without 205.0_ C92.0 C92.0_
maturation 205.0_ C92.0 C92.0_
206.0_ C93.0 C93.0_
9874 Acute myeloid leukemia with 205.0_ C92.0 C92.A_
maturation 205.0_ C92.0 C92.0_
205.0_ C92.0 C92.6_
9891 Acute monnoblastic and
monocytic leukemia

9895 Acute myeloid leukemia with
myelodysplasia-related changes

9896 Acute myeloid leukemia,
t(8;21)(q22;q22) RUNX1-RUNX1T1

9897 Acute myeloid leukemia with
t(9;11)(p22;q23);MLLT3-MLL

Acute Myeloid Leukemia (AML)
and Related Precursors(Table B5)

ICD-O-3 Code and Histology ICD-9- ICD-10 ICD-10-
CM CM

9898 Myeloid leukemia associated with 205.8_ 205.8_ C92.Z_
Down Syndrome 207.2_ C94.2_
205.0_ C92.0_
9910 Acute megakaryoblastic leukemia 207.2_
205.0_ C92.0_
9911 Acute myeloid leukemia 205.0_ 205.3_ C92.3_
(megakaryoblastic) with 205.0_ 238.79 C94.4_
t(1;22)(p13;q13);RBM15-MKL1

9920 Therapy related myeloid neoplasm

9930 Myeloid sarcoma 205.3_
238.79
9931 Acute panmyelosis with
myelofibrosis

Acute Leukemia of Ambiguous
Terminology (Table B6)

ICD-O-3 Code and Histology ICD-9- ICD-10 ICD-10-
CM CM
9800 Leukemia, NOS C95.9
208.9_ C95.1_;
9801 Acute undifferentiated leukemia C95.0 C95.9_
9805 Acute biphenotypic leukemia 208.0_ C95.0 C95.0_
9806 Mixed phenotype acute leukemia 208.0_ C95.0
208.0_ C95.0_
with t(9;22)(q34;q11.2);BCR-ABL1
C95.0_
9807 Mixed phenotype acute leukemia
with t(v;11q23); MLL rearranged 208.0_ C95.0 C95.0_
208.0_ C95.0 C95.0_
9808 Mixed phenotype acute leukemia, 208.0_ C95.0 C95.0_
B/myeloid, NOS

9809 Mixed phenotype acute leukemia,
T/myeloid, NOS

Precursor Lymphoid Neoplasm 2/21/2012
(Table B7) 23

ICD-O-3 Code and Histology ICD-9- ICD-10 ICD-10-
CM C83.5 CM
9728 Precursor B lymphoblastic
lymphoma 200.1_ C83.5_

9729 Precursor T-cell lymphoblastic 200.1_ C83.5 C83.5_
lymphoma, NOS
204.8_ C91.7 C91.Z_
9811 B lymphoblastic
leukemia/lymphoma, NOS 204.8_ C91.7 C91.Z_

9812 B Lymphoblastic
leukemia/lymphoma with
t(9;22)(q34;q11.2); BCR-ABL1

Precursor Lymphoid Neoplasm
(Table B7)

ICD-O-3 Code and Histology ICD-9- ICD-10 ICD-10-
CM C91.7 CM
9813 B Lymphoblastic
leukemia/lymphoma with 204.8_ C91.Z_
t(v;11q23); MLL rearranged
204.8_ C91.7 C91.Z_
9814 B Lymphoblastic
leukemia/lymphoma with 204.8_ C91.7 C91.Z_
t(12;21)(p13;q22); TEL-AML1 204.8_ C91.7 C91.Z_
(ETV6-RUNX1

9815 B Lymphoblastic
leukemia/lymphoma with
hyperdiploidy

9816 B Lymphoblastic
leukemia/lymphoma with
hypodiploidy (Hypodiploid ALL)

Precursor Lymphoid Neoplasm
(Table B7)

ICD-O-3 Code and Histology ICD-9- ICD-10 ICD-10-
CM C91.7 CM
9817 B Lymphoblastic
leukemia/lymphoma with 204.8_ C91.7 C91.Z_
t(5;14)(q31;q32); IL3-IGH
204.8_ C91.0 C91.Z_
9818 B Lymphoblastic C91.0
leukemia/lymphoma with t(1;19) 204.0_ C91.7 C91.0_
(q23;p13.3);E2A-PBX1 (TCF3-PBX1 204.0_ C91.0_
204.8_ C91.Z_
9835 Precursor cell lymphoblastic
leukemia, NOS

9836 Precursor B-cell lymphoblastic
leukemia

9837 Adult T-cell leukemia/lymphoma

Mature B-Cell Neoplasms (Table B8) 2/21/2012
24
ICD-O-3 Code and Histology ICD-9- ICD-10 ICD-10-
CM CM
C85.9
9590 Malignant lymphoma 202.8_ C85.9 C85.9_
C85.9 C85.1_,
9591 Malignant lymphoma, non-Hodgkin, 202.8_ C85.7 C85.9_
C83.0 C85.9_
NOS C83.0
C83.1 C82.6_
9596 Composite Hodgkin and non- 202.8_
C83.0_
Hodgkin lymphoma
C83.0_
9597 Primary cutaneous follicle centre 202.0_
C83.1_
lymphoma

9670 Malignant lymphoma, small B 200.8_

lymphocytic, NOS

9671 Malignant lymphoma, 200.8_

lymphoplasmacytic

9673 Mantle cell lymphoma (MCL) 200.4_

Mature B-Cell Neoplasms (Table B8)

ICD-O-3 Code and Histology ICD-9- ICD-10 ICD-10-
CM CM
C83.8
9678 Primary effusion lymphoma 200.8_ C83.3 C83.8_
C83.3 C85.2_
9679 Mediastinal large B-cell lymphoma 200.7_ C83.3_
C83.3
9680 Malignant lymphoma, large B-cell, 200.7_ C83.3_
diffuse, NOS 200.8_ C83.7
200.2_ C83.3 C83.7_
9684 Malignant lymphoma, large B-cell C83.3_
diffuse, immunoblastic, NOS C83.0
C83.0_
9687 Burkitt lymphoma, NOS

9688 T-cell/histiocyte-rich large B-cell 200.7_
lymphoma 200.3_

9689 Splenic marginal zone B-cell
lymphoma

Mature B-Cell Neoplasms (Table B8)

ICD-O-3 Code and Histology ICD-9- ICD-10 ICD-10-
CM CM
9690 Follicular lymphomas, NOS C82.9
202.0_ C82.1 C82.8_;
9691 Follicular lymphoma, grade 2 C82.0 C82.9_
9695 Follicular lymphoma, grade 1 202.0_ C82.2 C82.1_
9698 Follicular lymphoma, grade 3 202.0_
202.0_ C85.1 C82.0_
9699 Marginal zone B-cell lymphoma, C83.8
NOS 200.3_ C82.2_;
C82.3_;
9712 Intravascular large B-cell 200.7_ C82.4_
lymphoma C83.0_;
C88.4
C83.8_

Mature B-Cell Neoplasms (Table B8) 2/21/2012
25
ICD-O-3 Code and Histology ICD-9- ICD-10 ICD-10-
CM CM
C90.2
9731 Solitary plasmactyoma of bone 203.8_ C90.0 C90.3_
C90.2 C90.0_
9732 Multiple Myeloma 203.0_ C83.3 C90.2_
C83.3 C83.3_
9734 Extraosseous plasmacytoma 203.8_ C85.7 C84.6_
C85.8_
9735 Plasmablastic lymphoma 200.7_

9737 Alk positive large B-cell lymphoma 200.6_

9738 Large B-cell lymphoma arising in 202.8_
HHVS-associated multicentric
Castleman disease

Mature B-Cell Neoplasms (Table B8)

ICD-O-3 Code and Histology ICD-9- ICD-10 ICD-10-
CM CM
9761 Waldenstrom Macroglobulinemia C88.0
9762 Heavy chain disease 273.3 C88.2 C88.0
9820 Lymphoid, leukemia, NOS 203.8_ C91.9 C88.2
9823 Chronic lymphocytic 204.9_ C91.1 C91.9_
204.1_ C91.1_
leukemia/small lymphocytic
lymphoma 204.8_ C91.7 C91.A_
9826 Burkitt cell leukemia 204.8_ C91.3 C91.3_
9832 Prolymphocytic leukemia, NOS 204.8_ C91.3 C91.3_
9833 B-cell prolymphocytic leukemia 202.4_ C91.4 C91.4_
9940 Hairy cell leukemia

Mature T-Cell and NK-Cell
neoplasms (Table B9)

ICD-O-3 Code and Histology ICD-9- ICD-10 ICD-10-
CM CM
9700 Mycosis Fungoides C84.0
9701 Sezary syndrome 202.1_ C84.1 C84.0_
9702 Mature T-cell lymphoma, NOS 202.2_ C84.4
202.7_ C84.1_
9705 Angioimmunoblastic T-cell C84.4
lymphoma 202.7_ C84.4_;
C84.7
9708 Subcutaneous panniculitis-like T- C86.5
cell lymphoma
202.8_ C84.5 C86.3
9709 Cutaneous T-cell lymphoma, NOS
202.8_ C84.5 C84.A_

Mature T-Cell and NK-Cell 2/21/2012
neoplasms (Table B9) 26

ICD-O-3 Code and Histology ICD-9- ICD-10 ICD-10-
CM CM
9714 Anaplastic large cell lymphoma, T
cell and Null cell type 200.6_ C83.3 C84.Z_

9716 Hepatosplenic T-cell lymphoma 202.8_ C84.5 C86.1
202.8_ C84.5 C86.2
9717 Enteropathy-associated T-cell
lymphoma 202.7_ C84.4 C86.6

9718 Primary cutaneous CD30-positive 202.8_ C84.5 C86.0
T-cell lymphoproliferative
disorders

9719 Extranodal NK/T cell lymphoma,
nasal type

Mature T-Cell and NK-Cell
neoplasms (Table B9)

ICD-O-3 Code and Histology ICD-9- ICD-10 ICD-10-
CM CM
C96.7
9724 Systemic EBV-positive T-cell 202.9_ C96.Z_
9725 lymphoproliferative disease of 202.8_ C85.7
childhood C84.4 C85.8_
Hydro vacciniforme-like lymphoma C91.5 C84.A_;
C91.7 C84.4_
9726 Primary cutaneous gamma delta T- 202.7_ C91.3 C91.5_
9827 cell lymphoma 204.8_ C94.7
9831 Adult T-cell leukemia/ lymphoma 204.8_ C91.Z_
9834 (HTLV-1 positive) 204.8_
T-cell large granular lymphocytic C91.6_
leukemia C94.8_
T-cell prolymphocytic leukemia

9948 Aggressive NK-cell leukemia 207.8_

Hodgkin Lymphoma (Table B10)

ICD-O-3 Code and Histology ICD-9- ICD- ICD-10-
CM 10 CM
9650 Hodgkin Lymphoma, NOS
201.9_ C81.3 C81.7;
9651 Hodgkin lymphoma, lymphocyte-rich C81.9_
201.4_ C81.7 C81.4_
9652 Hodgkin lymphoma, mixed cellularity, NOS 201.6_ C81.2
201.7_ C81.3 C81.2_
9653 Hodgkin lymphoma, lymphocyte depletion,
NOS C81.3_

9654 Hodgkin lymphoma, lymphocytic depletion, 201.7_ C81.3 C81.3_
diffuse fibrosis
201.7_ C81.3 C81.3_
9655 Hodgkin lymphoma, lymphocyte depletion,
reticular

Hodgkins Lymphoma (Table B10) 2/21/2012
27
ICD-O-3 Code and Histology ICD-9- ICD- ICD-10-
CM 10 CM
9659 Hodgkin lymphoma, nodular lymphocyte
predominance 201.4_ C81.0 C81.0_

9663 Hodgkin lymphoma, nodular sclerosis, NOS 201.5_ C81.1 C81.1_
201.5_ C81.1 C81.1_
9664 Hodgkin lymphoma, nodular sclerosis,
9665 cellular phase 201.5_ C81.1 C81.1_
9667 Hodgkin lymphoma, nodular sclerosis,
grade I 201.5_ C81.1 C81.1_
Hodgkin lymphoma, nodular sclerosis,
grade 2

Histiocytic and Dendritic Cell
Neoplasms(Table B11)

ICD-O-3 Code and Histology ICD-9- ICD- ICD-10-
CM 10 CM
9751 Langerhans cell histiocytosis
9754 Langerhans' cell histiocytosis, 202.5_ C96.0 C96.0

disseminated 202.5_ C96.0 C96.0
9755 Histiocytic sarcoma
9756 Langerhans cell sarcoma 202.9_ C96.7 C96.A
9757 Interdigitating dendritic cell sarcoma 202.9_ C96.7 C96.4
9758 Follicular dendritic cell sarcoma 202.9_ C96.7 C96.4
9759 Fibroblastic reticular cell tumor 202.9_ C96.7 C96.4
202.9_ C96.7 C96.4

Post-Transplant
Lymphoproliferative Disorder
(PTLD) (Table B12)

ICD-O-3 Code and Histology ICD-9- ICD- ICD-10-
CM 10 CM
9971 Polymorphic Post Transplant
Lymphoproliferative Disorder (PTLD) 238.77 D47.7 D47.Z1

Review of 2/21/2012
Hematopoietic coding 28

A review of primary site/histology
coding from the Hematopoietic
Database

Coding guidelines

 Table B1: Myeloproliferative
Neoplasms

• Histologies: 9742, 9875, 9950, 9961,
9962, 9963, 9964, 9975

• Primary site ALWAYS coded C42.1
• CS Extension=800
• Summary Stage=7

Coding guidelines

 Table B2: Myeloid and Lymphoid
Neoplasms with Eosinophilia and
Abnormalities of PDGFRA, PDFFRB
or FGFR1

• Histologies: 9965, 9966, 9967
• Histologies effective 1/1/2010
• Primary site ALWAYS coded C42.1
• CS Extension=800
• Summary Stage=7

Coding guidelines 2/21/2012
29
 Table B3: Myelodysplastic/
Myeloproliferative Neoplasms

• Histologies: 9876, 9945, 9946, 9975
• Primary site ALWAYS coded C42.1
• CS Extension=800
• Summary Stage=7

Coding guidelines

 Table B4: Myelodysplastic
syndromes

• Histologies: 9980, 9982, 9983, 9985,
9986, 9989, 9991, 9992

• Primary site ALWAYS coded C42.1
• Histologies 9991 and 9992 effective

1/1/2010
• CS Extension=800
• Summary Stage=7

Coding guidelines

 Table B4: Myelodysplastic
syndromes

• 9987: Therapy-related myelodysplastic
syndrome, NOS [OBS]

– No longer applicable starting in 2010

• See code 9920: Therapy related myeloid
neoplasm

Coding guidelines 2/21/2012
30
 Table B5: AML and Related Precursor
Neoplasms

• Histologies: 9727, 9840, 9861, 9865, 9869, 9870-
9874, 9891-9898, 9910, 9911, 9920, 9931

• Primary site ALWAYS coded C42.1
• Histologies 9865, 9869, 9898, 9911 effective

1/1/2010
• CS Extension=800
• Summary Stage=7

Coding guidelines

 Table B6: Acute Leukemia of
ambiguous lineage

• Histologies: 9801, 9805-9809
• Primary site ALWAYS coded C42.1
• Histologies 9806-9809 effective 1/1/2010
• Histology 9805 OBSOLETE as of 1/1/2010
• CS Extension=800
• Summary Stage=7

Coding guidelines

 Table B7: Precursor Lymphoid
Neoplasms

• Histologies: 9811-9818, 9837
• Histologies 9811-9818 effective 1/1/2010
• CS Schemas: Lymphoma, Lymphoma

Ocular Adnexa or HemeRetic depending
on primary site

– Usually leukemia (HemeRetic schema)

Coding guidelines 2/21/2012
31
 Table B8: Mature B-Cell Neoplasms

• Primary site based on presentation for
most lymphomas

• If you have a lymphoma with only evidence
in bone marrow:

– Code primary site C42.1 (Bone Marrow)
– CS Extension=800
– Summary Stage=7

Coding guidelines

 Table B8: Mature B-Cell Neoplasms

• Primary site based on presentation for
most lymphomas

• 9596: B-cell lymphoma, unclassifiable

– Primary Site C77.0-C77.9 (lymph nodes)

• 9597: Primary cutaneous follicle centre
lymphoma

– Primary Site C44.0-C44.9 (skin)

Coding guidelines

 Table B8: Mature B-Cell Neoplasms

• 9688: T-cell/histiocytic rich large B-cell
lymphoma

– Primary Site C44.0-C44.9 (skin)

• 9689: Splenic marginal zone lymphoma

– Primary Site C42.2 (Spleen)
– Note: 9699 (Extranodal marginal zone

lymphoma) should NOT be coded to C42.2

Coding guidelines 2/21/2012
32
 Table B8: Mature B-Cell Neoplasms

• 9731: Solitary plasmacytoma of bone

– Primary site MUST be C40.0-C41.9
– CS Extension MUST be 110, 200, 400, 500 or 999
– CS Lymph Nodes and Mets are 988
– Summary Stage applicable for codes 1, 7, 9

• 9734: Extraosseous plasmacytoma

– Primary site CANNOT be coded to C40.0-C41.9
– CS Extension MUST be 300, 400, 999
– CS Lymph nodes applicable
– Summary Stage applicable for code 1-9

Coding guidelines

 Table B8: Mature B-Cell Neoplasms

• 9732: Multiple Myeloma

– Primary site MUST be C42.1
– CS Extension MUST be 810 or 820
– CS Lymph Nodes and Mets=988
– Summary Stage MUST be 7

• 9733: Plasma cell leukemia

– Per new rules (to be release 4/2012), Plasma cell
leukemia is to be coded as Multiple Myeloma
(9732)

Coding guidelines

 Table B8: Mature B-Cell Neoplasms

• 9761: Waldenstrom Macroglobulinemia

– Primary Site C42.0 (Blood)
– CS Extension=800, Summary Stage=7

• 9940: Hairy Cell Leukemia

– Primary Site C42.1
– Collected in HemeRetic schema
– CS Extension=800, Summary Stage=7
– Hairy Cell Leukemia variant coded to 9591/3

Coding guidelines 2/21/2012
33
 Table B9: Mature T-Cell and NK-Cell
Neoplasms

• Skin associated lymphomas (C44.0-C44.9)

– 9700, 9701, 9709, 9725

• 9708: Subcutaneous panniculitis-like T-
cell lymphoma

– Primary sites C49.0-C49.9

• 9726: Primary cutaneous gamma-delta T-
cell lymphoma

– Primary sites include C44.0-C44.9, C49.0-C49.9

Coding guidelines

 Table B9: Mature T-Cell and NK-Cell
Neoplasms

• 9716: Hepatosplenic T-cell lymphoma

– Primary site C42.2 (Spleen)

• 9827: Adult T-cell leukemia/lymphoma

– Primary site C77.0-C77.9 (Lymphoma schema)
– Primary site C42.1 (HemeRetic schema)

• 9831 and 9948: Leukemias

– Primary site C42.1

Coding guidelines

 Table B10: Hodgkin’s lymphomas

• Histologies: 9650, 9651, 9652, 9653, 9654,
9655, 9659, 9663, 9664, 9665, 9667

• Predominantly involves lymph nodes
• Primary rarely in extranodal sites
• Default primary sites: C77.0-C77.9

Coding guidelines 2/21/2012
34
 Table B11: Histiocytic and Dendritic
Cell Neoplasms

• Histologies: 9751, 9755-9759

– Note: Histologies 9752, 9753 and 9754 are no
longer used and should be coded as 9751/3.

• Collected in HemeRetic schema
• Applicable CS Extension codes:

– 100: Localized
– 800: Systemic
– 999: Unknown

Coding guidelines

 Table B12: Post-Transplant
Lymphoproliferative Disorders
(PTLD)

• No default primary site
• Refer to abstractor notes for instructions

on coding primary site

Recent News: 2/16/12

 HHS Announces Intent to Delay ICD-10
Compliance Date:

 “As part of President Obama’s commitment to
reducing regulatory burden, Health and Human
Services Secretary Kathleen G. Sebelius today
announced that HHS will initiate a process to
postpone the date by which certain health care
entities have to comply with International
Classification of Diseases, 10th Edition diagnosis
and procedure codes (ICD-10).”

 http://www.hhs.gov/news/press/2012pres/02/20120216a.html

ICD-10-CM Workgroup response: 2/21/2012
35
 NCRA webinars to continue as
planned (including May webinar)

 Current and planned work to
continue until a new
implementation date set

ICD-10-CM Workgroup response:

 If delay is only till 2014, no
change in planned work, schedule

 If delay is beyond 2014, group will
meet to decide on how to go
forward

AHIMA Response

 Does not support delay
 Reiterates that this release does

not say ICD-10-CM delay will
happen
 No comment on changes to CEU
requirements

http://www.ahima.org/downloads/pdfs/pr/press-
releases/Continue_Call_for_Progress_in_ICD.pdf

2/21/2012

Resources
 Link to Classifications of Diseases,

Functioning and Disability (ICD
coding systems)
 http://www.cdc.gov/nchs/icd.htm

Contact

Jennifer Ruhl, RHIT, CCS, CTR
301-594-8494
[email protected]

Jennifer Ruhl is a Public Health Analyst for the
National Cancer Institute’s Surveillance, Epidemiology
and End Results Program (NCI SEER). The findings and
conclusions in this presentation are those of the
author(s) and do not necessarily represent the official
position of NCI SEER.

36