Lymphoma, NOS

ICD10 Diagnosis
Dx:	Lymphoma, NOS
ICD10 code:	C85.8
Pre-ICD10 counterpart:	none assigned
Charlson/ALERT Scale:	none
APACHE Como Component:	none
APACHE Acute Component:	none
Start Date:
Stop Date:
Data Dependencies(Reports/Indicators/Data Elements):	No results
External ICD10 Documentation	ICD-10 CM Wikipedia ICD-10 Wikipedia WHO ICD10 documentation ICD10data.com

This diagnosis is a part of ICD10 collection.

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  • 2019-01-01
  • 2999-12-31
  • C85.8

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Additional Info

Lymphoma is cancer that begins in infection-fighting cells of the immune system, called lymphocytes.

Includes:

• other rarer lymphomas for which we don't include specific codes
• Marginal zone lymphoma

Excludes

• Non-Hodgkin's lymphoma
• Hodgkin's lymphoma (Hodgkin's disease)
• T-cell lymphoma

Leukemia vs Lymphoma

Any lymphoma may have a leukemic phase where the abnormal clonal cells appear in the circulation. Though this is sometimes referred to as a "leukemia", even by some oncologists, that is technically incorrect and ICD10 considers them to be lymphomas. This applies to essentially ALL so-called B-cell leukemias, which are actually lymphomas. It also applies to "NK-cell leukemia" which is also a lymphoma

As such, the following so-called "leukemias" should be coded as follows:

• So-called B-cell leukemias describes several different types of lymphoid lymphomas which affect B cells -- and all these should be coded as Lymphoma, NOS
  • "B cell chronic lymphocytic leukemia"
  • "Precursor B cell lymphoblastic leukemia"
  • "Acute Lymphoblastic leukemia, mature B cell type"
  • "B cell prolymphocytic leukemia"

• So-called "NK-cell leukemia" -- code as T-cell lymphoma
  • Aggressive NK-cell leukemia (also called aggressive NK-cell lymphoma, or ANKL), is a very rare type of NHL. The body makes large numbers of NK cells that are larger than normal. It is grouped with T-cell lymphomas.
  • There is a very rare slow-growing (indolent) type of NK-cell leukemia that has a more favorable prognosis. It is called chronic NK-cell leukemia and is treated like T-cell large granular lymphocytic leukemia.
• The most common type of lymphoid leukemia is B-cell chronic lymphocytic leukemia.

Using ICD10 Malignancy Codes as a Comorbid Diagnosis

• Any cancer/malignancy (either a "solid tumor" or a leukemia/lymphoma/bone marrow malignancy/"liquid tumor", i.e. any ICD10 code from C00-C99) can be a comorbid diagnosis --- BUT it's vital to distinguish malignancies in this category based on whether they are believed to be cured or not.

• If it's still present (or believed to be present), then just include the code for the specific cancer as a comorbid diagnosis.
• If INSTEAD, it's presumed cured, then in the "bin" of comorbid diagnoses combine the code for the specific cancer with this code: Past history, cancer (any type), believed cured

C00-C99 codes codes:

Metastases

Metastasis codes:

Regarding Presumptive Diagnosis of Malignancy

• Rarely a presumptive diagnosis is made without any tissue confirmation. This generally occurs with:
  1. risk of obtaining tissue is very high
  2. plan would be palliative regardless
  3. patient would refuse care regardless.
• Our issue for how to code a presumed malignancy without definitive histopathologic proof is this:
  • If the physicians are going to proceed with a treatment plan without that definitive histopathologic proof --- then code whatever is their best guess about what is present. Example: believed to be lung cancer with a big brain met, and they've decided NOT to do any biopsy but to give palliative radiation therapy, then you'd code lung cancer, and met to brain.
  • If the plan is to obtain a definitive histopathologic diagnosis soon or in the future, then instead code: Neoplasm of uncertain behavior (i.e. not clear if benign or malignant), NOS

"work-up for cancer"

If the cancer has not been confirmed then it should not be coded as cancer. Code relevant test abnormal test results or symptoms.

Testing codes:

Symptom/Sign codes:

Example:

"I have a patient who comes in with vague respiratory and gi symptoms. They did a chest xray and found a lung mass. They are now working him up for a probable lung ca, with mets to various places. In the old coding I would use ca-nyd. I actually use the ca nyd subcode a lot. I’ve talked to you about this before, because there is no ca nyd in icd10. You told me that you either have cancer or you don’t. For this particular patient I really wouldn’t have anything else I could code in icd10 for him. His symptoms are extremely vague. I don’t really like coding just symptoms, if there isn’t a proper admit diagnosis that fits better anyway. I found a “neoplasm of uncertain behavior (i.e. uncertain if benign or malignant), nos”, but I don’t really like that one. It doesn’t really fit. Is it possible to get something like “admit for workup of malignancy”, or something along those lines?" (Debbie, 12:40, 2018 October 4 (CDT)) How should this be coded? Ttenbergen 12:40, 2018 October 4 (CDT)

Alternate ICD10s to consider coding instead or in addition

Lymphoma codes:

• Disorder of lymph nodes and/or lymph vessels, noninfective NOS

Candidate Combined ICD10 codes

Related CCI Codes

Data Integrity Checks (automatic list)

none found

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