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C96.22 ICD-10-CM Code: Mast cell sarcoma

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

Coding at a Glance

Tabular directives
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 v43, Appendix B.

  • MS-DRG 011 — TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC (MDC PRE)
  • MS-DRG 012 — TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC (MDC PRE)
  • MS-DRG 013 — TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CC/MCC (MDC PRE)
  • 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)

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 21 — Lymphoma and Other Cancers (supersedes 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 C96.22 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2026Effective: October 1, 2025

Notes without a marker are published on C96.22 itself; “inherited from” names the category or block whose note applies here.

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).

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 C96.22

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

Before you code C96.22

  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 C96.22. 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 C96.22’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.

    ReviewD47.02, C94.30, Q82.2, Z85.79

Consider C96.22. 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.
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 C96.22(4 notes)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with C96.22: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    CompareD47.02, C94.30, Q82.2, Z85.79

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

  • Excludes2 — not part of C96.22(4 notes)

    Coding workflow: The conditions named in this note are not included in C96.22. 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 C96.22 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).

ReviewD47.02, C94.30, Q82.2, Z85.79

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.

Code Overview

Mast cell sarcoma is a billable ICD-10-CM diagnosis code (C96.22).

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

Indexed Clinical Terms (2)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

Verify Before Coding

  • CC as a secondary diagnosis (FY2026). 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 C96.22 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 6 Excludes1 notes across 3 chapters: C76 — Malignant neoplasm of other and ill-defined sites (via C96.-), C77 — Secondary and unspecified malignant neoplasm of lymph nodes (via C96.-), D47.0 — Mast cell neoplasms of uncertain behavior (via C96.2.-), D89.4 — Mast cell activation syndrome and related disorders (via C96.2.-), D89.4 — Mast cell activation syndrome and related disorders, Q82.2 — Congenital cutaneous mastocytosis (via C96.2.-).

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

Referenced by 2 Code First instructions across 2 chapters: N16 — Renal tubulo-interstitial disorders in diseases classified elsewhere, Z15.0 — Genetic susceptibility to malignant neoplasm (via C96.-).

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 (FY2026)

Potential MS-DRG participation — not a DRG assignment.

FY2026 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 50 clinically related codes on its CMS exclusion list.

Named in the grouper logic of 12 MS-DRGs: DRG 011 (MDC PRE), DRG 012 (MDC PRE), DRG 013 (MDC PRE), 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) +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):NEO024 — Sarcoma (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.

C85.2A — Mediastinal (thymic) large B-cell lymphoma, in remission, C85.80 — Other specified types of non-Hodgkin lymphoma, unspecified site, C85.89 — Other specified types of non-Hodgkin lymphoma, extranodal and solid organ sites, C85.8A — Other specified types of non-Hodgkin lymphoma, in remission, C85.90 — Non-Hodgkin lymphoma, unspecified, unspecified site, C85.99 — Non-Hodgkin lymphoma, unspecified, extranodal and solid organ sites, C85.9A — Non-Hodgkin lymphoma, unspecified, in remission, C86.40 — Blastic NK-cell lymphoma not having achieved 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, C96.20 — Malignant mast cell neoplasm, unspecified, C96.21 — Aggressive systemic mastocytosis, C96.29 — Other malignant mast cell neoplasm, 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, +29 more

Same CMS-HCC risk category (V28)

CMS maps these diagnoses to the same Hierarchical Condition Category (Lymphoma and Other Cancers) for risk-adjusted payment.

C88.31 — Immunoproliferative small intestinal disease, 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, C88.80 — Other malignant immunoproliferative diseases not having achieved remission, C88.81 — Other malignant immunoproliferative diseases, in remission, C88.90 — Malignant immunoproliferative disease, unspecified not having achieved remission, C88.91 — Malignant immunoproliferative disease, unspecified, in remission, C96.0 — Multifocal and multisystemic (disseminated) Langerhans-cell histiocytosis, C96.20 — Malignant mast cell neoplasm, unspecified, C96.21 — Aggressive systemic mastocytosis, C96.29 — Other malignant mast cell neoplasm, C96.4 — Sarcoma of dendritic cells (accessory cells), C96.5 — Multifocal and unisystemic Langerhans-cell histiocytosis, C96.6 — Unifocal Langerhans-cell histiocytosis, C96.9 — Malignant neoplasm of lymphoid, hematopoietic and related tissue, unspecified, C96.A — Histiocytic sarcoma, C96.Z — Other specified malignant neoplasms of lymphoid, hematopoietic and related tissue, D47.1 — Chronic myeloproliferative disease, D47.9 — Neoplasm of uncertain behavior of lymphoid, hematopoietic and related tissue, unspecified, D47.Z1 — Post-transplant lymphoproliferative disorder (PTLD), +442 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, Myelodysplastic Syndromes, Multiple Myeloma, and Other Cancers, Lung and Other Severe 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 (Sarcoma).

C46.50 — Kaposi's sarcoma of unspecified lung, C46.51 — Kaposi's sarcoma of right lung, C46.52 — Kaposi's sarcoma of left lung, C46.7 — Kaposi's sarcoma of other sites, C46.9 — Kaposi's sarcoma, unspecified, C49.0 — Malignant neoplasm of connective and soft tissue of head, face and neck, C49.10 — Malignant neoplasm of connective and soft tissue of unspecified upper limb, including shoulder, C49.11 — Malignant neoplasm of connective and soft tissue of right upper limb, including shoulder, C49.12 — Malignant neoplasm of connective and soft tissue of left upper limb, including shoulder, C49.20 — Malignant neoplasm of connective and soft tissue of unspecified lower limb, including hip, C49.21 — Malignant neoplasm of connective and soft tissue of right lower limb, including hip, C49.22 — Malignant neoplasm of connective and soft tissue of left lower limb, including hip, C49.3 — Malignant neoplasm of connective and soft tissue of thorax, C49.4 — Malignant neoplasm of connective and soft tissue of abdomen, C49.5 — Malignant neoplasm of connective and soft tissue of pelvis, C49.6 — Malignant neoplasm of connective and soft tissue of trunk, unspecified, C49.8 — Malignant neoplasm of overlapping sites of connective and soft tissue, C49.9 — Malignant neoplasm of connective and soft tissue, unspecified, C96.4 — Sarcoma of dendritic cells (accessory cells), C96.A — Histiocytic sarcoma, +5 more

Same Index main term, other category

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

C22.3 — Angiosarcoma of liver (Kupffer cell), C22.4 — Other sarcomas of liver (liver NEC), C41.0 — Malignant neoplasm of bones of skull and face (odontogenic, upper jaw), C41.1 — Malignant neoplasm of mandible (odontogenic), C46.0 — Kaposi's sarcoma of skin (Kaposi's, skin), C46.1 — Kaposi's sarcoma of soft tissue (Kaposi's, connective tissue), C46.2 — Kaposi's sarcoma of palate (Kaposi's, palate), C46.3 — Kaposi's sarcoma of lymph nodes (Kaposi's, lymph node), C46.4 — Kaposi's sarcoma of gastrointestinal sites (Kaposi's, colon), C46.5 — Kaposi's sarcoma of lung (Kaposi's, lung), C46.7 — Kaposi's sarcoma of other sites (Kaposi's, specified site NEC), C46.9 — Kaposi's sarcoma, unspecified (Kaposi's, unspecified site), C54.0 — Malignant neoplasm of isthmus uteri (stromal, isthmus), C54.1 — Malignant neoplasm of endometrium (stromal), C71.6 — Malignant neoplasm of cerebellum (cerebellar), C71.9 — Malignant neoplasm of brain, unspecified (monstrocellular, unspecified site), C92.3 — Myeloid sarcoma (myeloid), C94.3 — Mast cell leukemia (leukemia), D47.02 — Systemic mastocytosis (disease, systemic tissue), D47.09 — Other mast cell neoplasms of uncertain behavior (tumor)

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.

Prothrombin Time Test and INR (PT/INR)

Contextual Map

Every relationship of C96.22 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 C96.22 with these 7 related codes in Claim Check

Hierarchy

Referenced by Excludes1 notes

Referenced by Code First instructions

Clinical classification (CCSR)

Risk adjustment (CMS-HCC)

  • HCC 21 — Lymphoma and Other Cancers [CMS-HCC]: “Lymphoma and Other Cancers — supersedes 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

  • Pre-MDC[MDC crossing]: “Pre-MDC — 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. 153 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2026
  • 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. 4,730 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2026

Index entries

  • Mast cell, sarcoma[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Sarcoma (of), mast cell[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026

Nearest codes (12)

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 FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v43.1 (April 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 — v43 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. "C96.22 — Mast cell sarcoma." ICD-10-CM FY2026. https://medcoder.ai/icd10/code/c96.22-mast-cell-sarcoma

Change history

  • FY2018 — October 1, 2017
    Added to the code set
    Mast cell sarcoma
    FY2018 changes

Nearest Codes in This Family

Official ICD-10-CM classifications closest to C96.22 in its code family, with their registry titles.

View all codes in the C96 family