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C77 vs C81.44

C77 (Secondary and unspecified malignant neoplasm of lymph nodes) compared with C81.44 (Lymphocyte-rich Hodgkin lymphoma, lymph nodes of axilla and upper limb), from the official CMS tabular data. Do not report these codes together: the official tabular list marks them Excludes1.

Relationship

Conflict

Excludes1 conflict

C77
Secondary and unspecified malignant neoplasm of lymph nodes
↔
C81.44
Lymphocyte-rich Hodgkin lymphoma, lymph nodes of axilla and upper limb

Not coded here — these two are mutually exclusive.

“malignant neoplasm of lymph nodes, specified as primary (C81-C86, C88, C96.-)”

An Excludes1 note means the two conditions cannot occur together, so the pair should not be reported for the same encounter. The sole exception is when the conditions are documented as unrelated to each other.

Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a

Informational

Excludes2 relationship

C81.44
Lymphocyte-rich Hodgkin lymphoma, lymph nodes of axilla and upper limb
↔
C77
Secondary and unspecified malignant neoplasm of lymph nodes

Distinct conditions — both may be reported.

“secondary and unspecified neoplasm of lymph nodes (C77.-)”

An Excludes2 note means the excluded condition is not part of the code above it, but a patient can have both. Report both when both are documented.

Source: CMS ICD-10-CM tabular instructional notes

Can these codes be reported together?

No — do not report together. C77 carries an Excludes1 note covering C81.44: “malignant neoplasm of lymph nodes, specified as primary (C81-C86, C88, C96.-)”

Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Yes, when both are documented. C81.44 carries an Excludes2 note covering C77: “secondary and unspecified neoplasm of lymph nodes (C77.-)”

Excludes2 marks distinct conditions — both may be reported when both are documented.

Side by side

C77Secondary and unspecified malignant neoplasm of lymph nodesC81.44Lymphocyte-rich Hodgkin lymphoma, lymph nodes of axilla and upper limb
Billing statusNon-billable header

Report instead: C77.0, C77.1, C77.2, C77.3, C77.4

Billable
ClassificationC00-D49 — Neoplasms (C00-D49)C00-D49 — Neoplasms (C00-D49)
DefinitionSecondary and unspecified malignant neoplasm of lymph nodes is a non-billable ICD-10-CM category code (C77).Lymphocyte-rich Hodgkin lymphoma, lymph nodes of axilla and upper limb is a billable ICD-10-CM diagnosis code (C81.44).
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Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources