Is C95.00 a billable ICD-10-CM code?

Yes. C95.00 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does C95.00 sit in the tabular list?

Neoplasms (C00-D49), in the block Malignant neoplasms of lymphoid, hematopoietic and related tissue (C81-C96).

C95.00

C95.00 — Acute leukemia of unspecified cell type not having achieved remission

Billable / specific codeICD-10-CM

C95.00 is a billable, specific ICD-10-CM code for acute leukemia of unspecified cell type not having achieved remission. It is valid for submission on a claim.

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Acute leukemia of unspecified cell type with failed remission
Acute leukemia NOS

Risk adjustment

C95.00 risk-adjusts. Under the CMS-HCC V28 model it maps to these categories:

HCC 18 Cancer Metastatic to Bone, Other and Unspecified Metastatic Cancer; Acute Leukemia Except Myeloid2.341 RAF
HCC 18 Cancer Metastatic to Bone, Other and Unspecified Metastatic Cancer; Acute Leukemia Except Myeloid2.341 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

C95.00 is named in 41 Medicare coverage policies — 39 listing it as supporting medical necessity, and 2 listing it as NOT covered. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A56462Billing and Coding: Erythropoiesis Stimulating Agents (ESA)not covered
A60435Billing and Coding: Erythropoiesis Stimulating Agents (ESA)not covered
A52480Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) - Policy Article
A54768Billing and Coding: Cardiac Blood Pool Imaging (Multiple Gated Acquisition Scanning- MUGA, Ventriculography) When Performed in Conjunction with Cardiotoxic Chemotherapy

Code history

C95.00 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share C95.0. If C95.00 is not quite right, the correct code is usually one of these.

Questions about C95.00

Is C95.00 a billable ICD-10-CM code?: Yes. C95.00 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does C95.00 sit in the tabular list?: Neoplasms (C00-D49), in the block Malignant neoplasms of lymphoid, hematopoietic and related tissue (C81-C96).