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C86.40 ICD-10-CM Code: Blastic NK-cell lymphoma not having achieved remission

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Coding at a Glance

Tabular directives
5 inclusion terms · 4 Excludes1 · 4 Excludes2
Risk adjustment
CMS-HCC V28: 1 category · CMS-HCC V22 category 10 · RxHCC V08 category 21

Inpatient Payment Groups (MS-DRG)

Potential MS-DRG participation — not a DRG assignment.

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v44, Appendix B.

  • MS-DRG 820 — LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH MCC (MDC 17)
  • MS-DRG 821 — LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH CC (MDC 17)
  • MS-DRG 822 — LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC (MDC 17)
  • MS-DRG 823 — LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH MCC (MDC 17)
  • MS-DRG 824 — LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH CC (MDC 17)
  • MS-DRG 825 — LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITHOUT CC/MCC (MDC 17)
  • MS-DRG 840 — LYMPHOMA AND NON-ACUTE LEUKEMIA WITH MCC (MDC 17)
  • MS-DRG 841 — LYMPHOMA AND NON-ACUTE LEUKEMIA WITH CC (MDC 17)
  • MS-DRG 842 — LYMPHOMA AND NON-ACUTE LEUKEMIA WITHOUT CC/MCC (MDC 17)
  • MS-DRG 974 — HIV WITH MAJOR RELATED CONDITION WITH MCC (MDC 25)
  • MS-DRG 975 — HIV WITH MAJOR RELATED CONDITION WITH CC (MDC 25)
  • MS-DRG 976 — HIV WITH MAJOR RELATED CONDITION WITHOUT CC/MCC (MDC 25)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Risk Adjustment (CMS-HCC)

Payment categories this diagnosis maps to under CMS-HCC V28, payment year 2026.

  • HCC 19 — Myelodysplastic Syndromes, Multiple Myeloma, and Other Cancers (supersedes HCC 20, HCC 21, HCC 22, HCC 23)

Other models: CMS-HCC V22 HCC 10 · RxHCC V08 HCC 21

Risk scores depend on the enrollee's full accepted diagnosis set and segment; a category mapping alone does not determine payment.

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for C86.40 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2027Effective: October 1, 2026

Trace:FY2027 changesChange historyRelease, file and checksum

Notes without a marker are published on C86.40 itself; “inherited from” names the category or block whose note applies here.

Inclusion Terms

Alternative terms the tabular list files under this code.

  • Blastic NK-cell lymphoma NOS
  • Blastic NK-cell lymphoma with failed remission
  • Blastic plasmacytoid dendritic cell neoplasm (BPDCN) NOS
  • Blastic plasmacytoid dendritic cell neoplasm (BPDCN) not having achieved remission
  • Blastic plasmacytoid dendritic cell neoplasm (BPDCN) with failed remission

Excludes1 — Not Coded Here

Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Source: inherited from C86

Excludes2 — Not Included Here

Conditions not covered by this code, but which may be reported alongside it when both are present.

Source: inherited from C81-C96

Coder workflow for C86.40

MedCoder structured workflow — derived from this code’s own official record

Before you code C86.40

  1. Confirm the documented site and behavior (this code’s block classifies malignant neoplasms), whether the site is primary or secondary, and whether the malignancy is current or a personal history: a previously excised malignancy with no further treatment and no evidence of disease is history, not current disease. Verify the site against the Table of Neoplasms. Neoplasm chapter guidelines (Guidelines I.C.2.a, I.C.2.d, I.C.2.m).

    See the Table of Neoplasms entries · Guide: Active cancer vs history of cancer →

  2. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with C86.40. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).

    See the official tabular notes

Choose the right path

  1. Does the documentation support a condition named in C86.40’s Excludes1 note?
    Yes → Do not simply proceed: review the excluded code. Both are reported only when the record shows the two conditions are unrelated.
    No → Continue.

    ReviewC84.7, C84.6, C84, C85.8

Consider C86.40. Then confirm the code is valid for the date of service in the Verify section.

Documentation check

The provider’s diagnostic statement
Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
Anatomical site
At the most specific level the record states; a site the classification separates cannot be assumed from a procedure or a measurement.
Remission status
Remission is coded only when the provider documents it.
Behavior and current-versus-history status
Malignant, in situ, benign or uncertain; primary or secondary; current disease or personal history (Guidelines I.C.2.m).

Official instructions as workflow

  • Excludes1 — check before selecting C86.40(4 notes)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with C86.40: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    CompareC84.7, C84.6, C84, C85.8

    See the official tabular notes · Guidelines I.A.12.a

  • Excludes2 — not part of C86.40(4 notes)

    Coding workflow: The conditions named in this note are not included in C86.40. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

    CompareC46.3, C77, C79.52, C78.89

    See the official tabular notes · Guidelines I.A.12.b

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Documentation: Both the condition C86.40 describes and a condition named in its Excludes1 note are documented for the same encounter.

Coding question: Can both codes be reported?

Path: Review the Excludes1 note and the excluded code, and look for a provider statement on whether the two conditions are related.

Reason: Excludes1 means the two are not coded together; the exception is when the record shows the conditions are unrelated to each other (Guidelines I.A.12.a).

ReviewC84.7, C84.6, C84, C85.8

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Don’t confuse C86.40 with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of C86.40 — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

  • C84.7— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of anaplastic large cell lymphoma, ALK negative moves the case to C84.7; the two are not reported together unless documented as unrelated.

    Full comparison: C86.40 vs C84.7 →

  • C84.6— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of anaplastic large cell lymphoma, ALK positive moves the case to C84.6; the two are not reported together unless documented as unrelated.

    Full comparison: C86.40 vs C84.6 →

  • C84— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of anaplastic large cell lymphoma, ALK negative moves the case to C84; the two are not reported together unless documented as unrelated.

    Full comparison: C86.40 vs C84 →

  • C85.8— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of other specified types of non-Hodgkin lymphoma moves the case to C85.8; the two are not reported together unless documented as unrelated.

    Full comparison: C86.40 vs C85.8 →

  • C46.3— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of Kaposi's sarcoma of lymph nodes adds C46.3; it is not part of this code and both may be reported when both are documented.

    Full comparison: C86.40 vs C46.3 →

  • C77— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of secondary and unspecified neoplasm of lymph nodes adds C77; it is not part of this code and both may be reported when both are documented.

    Full comparison: C86.40 vs C77 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

Code Overview

Blastic NK-cell lymphoma not having achieved remission is a billable ICD-10-CM diagnosis code (C86.40).

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Verify Before Coding

  • CC as a secondary diagnosis (FY2027). Can raise the stay's MS-DRG severity tier.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder structured relationships — computed from published CMS and AHRQ datasets

Other codes that name C86.40 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 4 Excludes1 notes: C76 — Malignant neoplasm of other and ill-defined sites (via C86.-), C77 — Secondary and unspecified malignant neoplasm of lymph nodes (via C86.-), C84.Z — Other mature T/NK-cell lymphomas, C85 — Other specified and unspecified types of non-Hodgkin lymphoma (via C86.-).

These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.

Referenced by 1 Code First instruction: Z15.0 — Genetic susceptibility to malignant neoplasm (via C86.-).

Each of these codes carries a Code First note naming this condition — when that code is reported, THIS code is sequenced first, ahead of it.

MS-DRG Grouper Relationships (FY2027)

Potential MS-DRG participation — not a DRG assignment.

FY2027 MS-DRG: CC — Complication or Comorbidity. Reported as a secondary diagnosis, this code raises the stay's MS-DRG severity tier — except when the principal diagnosis is one of 151 clinically related codes on its CMS exclusion list. Does not count toward severity when the stay groups to DRGs 974-976 (HIV with Major Related Condition).

Named in the grouper logic of 12 MS-DRGs: DRG 820 (MDC 17), DRG 821 (MDC 17), DRG 822 (MDC 17), DRG 823 (MDC 17), DRG 824 (MDC 17), DRG 825 (MDC 17), DRG 840 (MDC 17), DRG 841 (MDC 17), DRG 842 (MDC 17), DRG 974 (MDC 25) +2 more.

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):NEO058 — Non-Hodgkin lymphoma (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same clinical process (MS-DRG)

Acts as CC — raises the severity of other admissions. CMS groups these diagnoses into one MS-DRG principal-diagnosis exclusion process — a CC/MCC on this list never raises severity when the principal diagnosis is also on it.

C85.98 — Non-Hodgkin lymphoma, unspecified, lymph nodes of multiple sites, C85.99 — Non-Hodgkin lymphoma, unspecified, extranodal and solid organ sites, C85.9A — Non-Hodgkin lymphoma, unspecified, in remission, C86.00 — Extranodal NK/T-cell lymphoma, nasal type not having achieved remission, C86.01 — Extranodal NK/T-cell lymphoma, nasal type, in remission, C86.10 — Hepatosplenic T-cell lymphoma not having achieved remission, C86.11 — Hepatosplenic T-cell lymphoma, in remission, C86.20 — Enteropathy-type (intestinal) T-cell lymphoma not having achieved remission, C86.21 — Enteropathy-type (intestinal) T-cell lymphoma, in remission, C86.30 — Subcutaneous panniculitis-like T-cell lymphoma not having achieved remission, C86.31 — Subcutaneous panniculitis-like T-cell lymphoma, in remission, C86.41 — Blastic NK-cell lymphoma, in remission, C88.40 — Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue [MALT-lymphoma] not having achieved remission, C88.41 — Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue [MALT-lymphoma], in remission, C96.4 — Sarcoma of dendritic cells (accessory cells), C96.9 — Malignant neoplasm of lymphoid, hematopoietic and related tissue, unspecified, C96.Z — Other specified malignant neoplasms of lymphoid, hematopoietic and related tissue, D49.81 — Neoplasm of unspecified behavior of retina and choroid, D49.89 — Neoplasm of unspecified behavior of other specified sites, D49.9 — Neoplasm of unspecified behavior of unspecified site, +130 more

Same CMS-HCC risk category (V28)

CMS maps these diagnoses to the same Hierarchical Condition Category (Myelodysplastic Syndromes, Multiple Myeloma, and Other Cancers) for risk-adjusted payment.

C84.74 — Anaplastic large cell lymphoma, ALK-negative, lymph nodes of axilla and upper limb, C84.75 — Anaplastic large cell lymphoma, ALK-negative, lymph nodes of inguinal region and lower limb, C84.76 — Anaplastic large cell lymphoma, ALK-negative, intrapelvic lymph nodes, C84.77 — Anaplastic large cell lymphoma, ALK-negative, spleen, C84.78 — Anaplastic large cell lymphoma, ALK-negative, lymph nodes of multiple sites, C84.79 — Anaplastic large cell lymphoma, ALK-negative, extranodal and solid organ sites, C84.7A — Anaplastic large cell lymphoma, ALK-negative, breast, C84.7B — Anaplastic large cell lymphoma, ALK-negative, in remission, C86.30 — Subcutaneous panniculitis-like T-cell lymphoma not having achieved remission, C86.31 — Subcutaneous panniculitis-like T-cell lymphoma, in remission, C86.41 — Blastic NK-cell lymphoma, in remission, C86.50 — Angioimmunoblastic T-cell lymphoma not having achieved remission, C86.51 — Angioimmunoblastic T-cell lymphoma, in remission, C90.00 — Multiple myeloma not having achieved remission, C90.01 — Multiple myeloma in remission, C90.02 — Multiple myeloma in relapse, C90.10 — Plasma cell leukemia not having achieved remission, C90.11 — Plasma cell leukemia in remission, C90.12 — Plasma cell leukemia in relapse, C90.20 — Extramedullary plasmacytoma not having achieved remission, +47 more

Related risk categories

These categories interact through CMS's HCC hierarchy — one can suppress the other's risk-adjustment weight when both are present on a claim.

Cancer Metastatic to Lung, Liver, Brain, and Other Organs; Acute Myeloid Leukemia Except Promyelocytic, Cancer Metastatic to Bone, Other and Unspecified Metastatic Cancer; Acute Leukemia Except Myeloid, Lung and Other Severe Cancers, Lymphoma and Other Cancers, Bladder, Colorectal, and Other Cancers, Prostate, Breast, and Other Cancers and Tumors

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Non-Hodgkin lymphoma).

+317 more

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main term “Lymphoma”; these codes share that main term but sit in a different category of the Tabular List.

C83.8 — Other non-follicular lymphoma (primary effusion B-cell), C83.9 — Non-follicular (diffuse) lymphoma, unspecified (non-follicular), C84.4 — Peripheral T-cell lymphoma, not elsewhere classified (Lennert's), C84.49 — Peripheral T-cell lymphoma, not elsewhere classified, extranodal and solid organ sites (primary central nervous system, peripheral T-cell), C84.6 — Anaplastic large cell lymphoma, ALK-positive (anaplastic large cell, ALK-positive), C84.7 — Anaplastic large cell lymphoma, ALK-negative (anaplastic large cell, ALK-negative), C84.7A — Anaplastic large cell lymphoma, ALK-negative, breast (anaplastic large cell, breast implant associated), C84.9 — Mature T/NK-cell lymphomas, unspecified (NK/T cell), C84.A — Cutaneous T-cell lymphoma, unspecified (cutaneous T-cell), C84.Z — Other mature T/NK-cell lymphomas (mature T/NK-cell, specified NEC), C85.1 — Unspecified B-cell lymphoma (B-cell), C85.2 — Mediastinal (thymic) large B-cell lymphoma (mediastinallarge B-cell), C85.8 — Other specified types of non-Hodgkin lymphoma (non-Hodgkin, specified NEC), C85.9 — Non-Hodgkin lymphoma, unspecified (histiocytic), C85.90 — Non-Hodgkin lymphoma, unspecified, unspecified site, C88.0 — Waldenström macroglobulinemia (lymphoplasmacytic, with IgM-production), C88.3 — Immunoproliferative small intestinal disease (Mediterranean), C88.4 — Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue [MALT-lymphoma] (BALT), C91.5 — Adult T-cell lymphoma/leukemia (HTLV-1-associated) (adult T-cell), C96.A — Histiocytic sarcoma (true histiocytic), +25 more

Lab tests where this diagnosis supports Medicare coverage (NCD)

Medicare's National Coverage Determination (NCD) program lists this diagnosis as medical justification for these lab tests.

Gamma-glutamyl Transferase (GGT) Test, Iron Panel, Prothrombin Time Test and INR (PT/INR)

Contextual Map

Every relationship of C86.40 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run C86.40 with these 5 related codes in Claim Check

Hierarchy

Referenced by Excludes1 notes

Referenced by Code First instructions

Clinical classification (CCSR)

Risk adjustment (CMS-HCC)

  • HCC 19 — Myelodysplastic Syndromes, Multiple Myeloma, and Other Cancers [CMS-HCC]: “Myelodysplastic Syndromes, Multiple Myeloma, and Other Cancers — supersedes HCC 20 (Lung and Other Severe Cancers), HCC 21 (Lymphoma and Other Cancers), HCC 22 (Bladder, Colorectal, and Other Cancers), HCC 23 (Prostate, Breast, and Other Cancers and Tumors)”— CMS-HCC V28 · 2026

MS-DRG Grouper (12)

MDC crossing

  • MDC 17 — Myeloproliferative Diseases and Disorders, Poorly Differentiated Neoplasms[MDC crossing]: “Myeloproliferative Diseases and Disorders, Poorly Differentiated Neoplasms — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 4,735 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2027

Nearest codes (21)

Change history

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data
CMS/CDC ICD-10-CM FY2027 tabular list, index and tables, effective October 1, 2026 Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v44.0 (October 2026) Release, file and checksum · Publisher’s page
Inpatient payment groups Official source data
CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v44 Release, file and checksum · Publisher’s page
Risk adjustment Official source data
2026 Mid-Year Final ICD-10 Mappings + Model Software (cms.gov/files/zip/2026-midyear-final-icd-10-mappings.zip, 2026-midyear-final-model-software.zip) — CMS-HCC V28, PY2026 mid-year final release Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data
CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder structured relationship
Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder explanation
Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "C86.40 — Blastic NK-cell lymphoma not having achieved remission." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/c86.40-blastic-nk-cell-lymphoma-not-having-achieved-remission

Change history

  • FY2025 — October 1, 2024
    Added to the code set
    Blastic NK-cell lymphoma not having achieved remission
    FY2025 changes

Nearest Codes in This Family

Official ICD-10-CM classifications closest to C86.40 in its code family, with their registry titles.

View all codes in the C86 family