Researchers have dedicated decades to advancing treatments for individuals diagnosed with malignant neoplasms, commonly referred to as cancer. Their efforts have yielded significant progress, as evidenced by the increasing number of patients diagnosed with this formidable disease who are living longer, healthier lives. In 2025, further proof of these advancements will be seen with the introduction of 47 new ICD-10-CM codes designed specifically for reporting lymphoma in remission.
The newly added codes will encompass the following categories:
- C81: Hodgkin lymphoma
- C82: Follicular lymphoma
- C83: Non-follicular lymphoma
- C84: Mature T/NK-cell lymphomas
- C85: Other specified and unspecified types of non-Hodgkin lymphoma
- C86: Other specified types of T/NK-cell lymphoma
- C88: Malignant immunoproliferative diseases and certain other B-cell lymphomas
The medical definition of remission in the context of malignant neoplastic conditions refers to a reduction or complete disappearance of cancer symptoms and signs for a minimum of one month (approximately 30 days), as outlined by the National Cancer Institute. It is crucial to note that even when a patient achieves complete remission, with no apparent signs or symptoms of cancer, malignant cells may still remain in the body. “Remission” and “no evidence of disease” are distinct from being “cancer-free,” which can only be confirmed through imaging or pathology testing.
The new ICD-10-CM codes to be introduced in 2025 specifically address lymphoma, a type of cancer characterized by the presence of malignant cells in the lymphatic system. Lymphoma involves abnormal white blood cells, known as lymphocytes. As part of the lymphatic system, which extends throughout the body, lymphoma can affect the lymph nodes, spleen, bone marrow, thymus, tonsils, and adenoids. Symptoms of lymphoma include fever, unexplained weight loss, night sweats, fatigue, and swollen lymph nodes. Malignant cells can be identified in these areas through physical examination, imaging, biopsy of any masses or cysts, and subsequent pathology testing.
Once a lymphoma diagnosis is confirmed, treatment plans are tailored based on the type and extent of cellular involvement. In the United States, approximately 80,000 individuals are diagnosed with Non-Hodgkin lymphoma each year, whereas Hodgkin lymphoma, a less common type, affects around 9,000 people annually. Standard treatment options for lymphoma include chemotherapy, immunotherapy, and radiation. Additionally, targeted therapies, which focus on specific molecular structures within the cancer cells, and chimeric antigen receptor (CAR) T-cell therapy, are also utilized in certain cases of lymphoma.
When treatment proves successful, the patient reaches the milestone of being classified as “in remission.” The corresponding new ICD-10-CM code is easily identifiable, as the term “in remission” is included in the description. However, additional details must be extracted from the patient’s medical records, whether from physician documentation or pathology reports, to ensure accurate coding. As outlined earlier, it is essential to know the specific type of malignancy—whether it is Hodgkin lymphoma, follicular lymphoma, non-follicular lymphoma, mature T/NK-cell lymphoma, or another subtype.
For Hodgkin lymphoma, the correct code depends on the specific subtype of the diagnosis:
- C81.0A: Nodular lymphocyte predominant Hodgkin lymphoma, in remission
- C81.1A: Nodular sclerosis Hodgkin lymphoma, in remission
- C81.2A: Mixed cellularity Hodgkin lymphoma, in remission
- C81.3A: Lymphocyte depleted Hodgkin lymphoma, in remission
- C81.4A: Lymphocyte-rich Hodgkin lymphoma, in remission
- C81.7A: Other Hodgkin lymphoma, in remission
For follicular lymphoma, documentation should reflect the grade of the malignancy, which is now in remission:
- C82.0A: Follicular lymphoma grade I, in remission
- C82.1A: Follicular lymphoma grade II, in remission
- C82.2A: Follicular lymphoma grade III, unspecified, in remission
- C82.3A: Follicular lymphoma grade IIIa, in remission
- C82.4A: Follicular lymphoma grade IIIb, in remission
Follicular lymphoma, grade 1, also known as follicular small-cleaved cell lymphoma, is characterized by the presence of 0-5 centroblasts per high-power field (HPF) in pathology reports. This is the least aggressive form of the malignancy. Grade 2, or follicular mixed-cell lymphoma, is identified by 6-15 centroblasts per HPF. Grade 3, known as follicular large cell lymphoma, is characterized by more than 15 centroblasts per HPF. Within grade 3, grade 3A displays centrocytes, while grade 3B presents as solid sheets of centroblasts. To determine the correct code, it may be necessary to refer to the pathology reports in the patient’s medical records. It is important to note that grade designations differ from the staging of malignancies, which represents a separate classification.
Other types of follicular and non-follicular lymphomas will be classified as follows:
- C82.5A: Diffuse follicle center lymphoma, in remission
- C82.6A: Cutaneous follicle center lymphoma, in remission
- C82.8A: Other types of follicular lymphoma, in remission
- C83.0A: Small cell B-cell lymphoma, in remission
- C83.1A: Mantle cell lymphoma, in remission
- C83.3A: Diffuse large B-cell lymphoma, in remission
- C83.5A: Lymphoblastic (diffuse) lymphoma, in remission
- C83.7A: Burkitt lymphoma, in remission
- C83.8A: Other non-follicular lymphoma, in remission
- C84.0A: Mycosis fungoides, in remission
- C84.1A: Sézary disease, in remission
- C84.4A: Peripheral T-cell lymphoma, not elsewhere classified, in remission
- C84.6A: Anaplastic large cell lymphoma, ALK-positive, in remission
- C84.7B: Anaplastic large cell lymphoma, ALK-negative, in remission
- C84.AA: Cutaneous T-cell lymphoma, unspecified, in remission
- C84.ZA: Other mature T/NK-cell lymphomas, in remission
- C84.9A: Mature T/NK-cell lymphomas, unspecified, in remission
- C85.1A: Unspecified B-cell lymphoma, in remission
- C85.2A: Mediastinal (thymic) large B-cell lymphoma, in remission
- C85.8A: Other specified types of non-Hodgkin lymphoma, in remission
- C85.9A: Non-Hodgkin lymphoma, unspecified, in remission
- C86.01: Extranodal NK/T-cell lymphoma, nasal type, in remission
- C86.11: Hepatosplenic T-cell lymphoma, in remission
- C86.21: Enteropathy-type (intestinal) T-cell lymphoma, in remission
- C86.31: Subcutaneous panniculitis-like T-cell lymphoma, in remission
- C86.41: Blastic NK-cell lymphoma, in remission
- C86.51: Angioimmunoblastic T-cell lymphoma, in remission
- C86.61: Primary cutaneous CD30-positive T-cell proliferations, in remission
- C88.01: Waldenström macroglobulinemia, in remission
- C88.21: Heavy chain disease, in remission
- C88.31: Immunoproliferative small intestinal disease, in remission
- C88.41: Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma), in remission
- C88.81: Other malignant immunoproliferative diseases, in remission
- C88.91: Malignant immunoproliferative disease, unspecified, in remission
As indicated, each of these codes corresponds to a specific type of lymphoma. Accurate reporting requires detailed documentation from both the physician and the pathologist, which should be included in the patient’s medical record.
The 2025 ICD-10-CM codes provide a standardized method for coding specialists to report the positive outcome that the patient is now in remission
- What is the primary characteristic of Follicular lymphoma grade 1?
Answer: Follicular lymphoma grade 1, also known as follicular small-cleaved cell lymphoma, is identified by 0-5 centroblasts per high-power field (HPF) in pathology reports. It is the least aggressive form of the malignancy. - How does Follicular lymphoma grade 2 differ from grade 1?
Answer: Follicular lymphoma grade 2, or follicular mixed-cell lymphoma, is characterized by 6-15 centroblasts per high-power field (HPF), making it more aggressive than grade 1. - What is the difference between grade 3A and grade 3B of follicular lymphoma?
Answer: Grade 3A of follicular lymphoma displays centrocytes, while grade 3B shows solid sheets of centroblasts, with grade 3B being more aggressive. - What is the key difference between “grade” and “stage” in lymphoma classification?
Answer: “Grade” refers to the histological characteristics of the cancer cells, such as the number of centroblasts, while “stage” refers to the extent of cancer spread in the body, and the two are distinct concepts. What is the significance of the 2025 ICD-10-CM codes for lymphoma?
Answer: The 2025 ICD-10-CM codes allow healthcare professionals to accurately report cases of lymphoma in remission, specifying the type and grade of lymphoma based on physician and pathology documentation.