C81.16
C81.16 — Nodular sclerosis Hodgkin lymphoma, intrapelvic lymph nodes
Billable / specific codeICD-10-CM
C81.16 is a billable, specific ICD-10-CM code for nodular sclerosis hodgkin lymphoma, intrapelvic lymph nodes. It is valid for submission on a claim.
Risk adjustment
C81.16 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 21 Lymphoma and Other Cancers0.671 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.
Medicare coverage
C81.16 is named in 51 Medicare coverage policies — 51 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A52479Oral Anticancer Drugs - Policy Article
- A52479Oral Anticancer Drugs - Policy Article
- A52479Oral Anticancer Drugs - Policy Article
- A52479Oral Anticancer Drugs - Policy Article
Related codes at this level
Codes that share C81.1. If C81.16 is not quite right, the correct code is usually one of these.
- C81.10Nodular sclerosis Hodgkin lymphoma, unspecified site
- C81.11Nodular sclerosis Hodgkin lymphoma, lymph nodes of head, face, and neck
- C81.12Nodular sclerosis Hodgkin lymphoma, intrathoracic lymph nodes
- C81.13Nodular sclerosis Hodgkin lymphoma, intra-abdominal lymph nodes
- C81.14Nodular sclerosis Hodgkin lymphoma, lymph nodes of axilla and upper limb
- C81.15Nodular sclerosis Hodgkin lymphoma, lymph nodes of inguinal region and lower limb
- C81.17Nodular sclerosis Hodgkin lymphoma, spleen
- C81.18Nodular sclerosis Hodgkin lymphoma, lymph nodes of multiple sites
- C81.19Nodular sclerosis Hodgkin lymphoma, extranodal and solid organ sites
- C81.1ANodular sclerosis Hodgkin lymphoma, in remission
Questions about C81.16
- Is C81.16 a billable ICD-10-CM code?
- Yes. C81.16 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does C81.16 sit in the tabular list?
- Neoplasms (C00-D49), in the block Malignant neoplasms of lymphoid, hematopoietic and related tissue (C81-C96).