Is ICD-10-CM code C95 billable?

No, C95 (Leukemia of unspecified cell type) is a non-billable ICD-10-CM code. It must be coded to a more specific subcategory before it can be used for reimbursement.

What chapter does ICD-10-CM code C95 belong to?

C95 belongs to Chapter 2 of the ICD-10-CM tabular list: C00–D49 (Neoplasms).

C95Not billable, use a more specific code below

Leukemia of unspecified cell type

In Malignant neoplasms of lymphoid, hematopoietic and related tissue (C81-C96), chapter 2: Neoplasms

9 billable codes under C95: all are a CC; all map to HCC 22 (Bladder, Colorectal, and Other Cancers), HCC 18 (Cancer Metastatic to Bone, Other and Unspecified Metastatic Cancer; Acute Leukemia Except Myeloid).A CC or MCC (major CC) is a secondary diagnosis that raises the MS-DRG payment. An HCC counts toward a Medicare Advantage patient's risk score.

Instructional notes

Excludes1: not coded here, use a different code

personal history of leukemia (Z85.6)

Also applies, from Malignant neoplasms of lymphoid, hematopoietic and related tissue (C81-C96)

These notes sit on C81-C96 and apply to every code under it, including C95.

Excludes2: not included here, code separately if applicable

Kaposi's sarcoma of lymph nodes (C46.3)
secondary and unspecified neoplasm of lymph nodes (C77.-)
secondary neoplasm of bone marrow (C79.52)
secondary neoplasm of spleen (C78.89)

Official coding guidelines

From the ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027 (CMS and NCHS). Links open the PDF at the right page.

Rules for coding benign and malignant neoplasms: using the Neoplasm Table, sequencing primary and secondary sites, treatment encounters, complications, and current cancer versus personal history.

Admission/Encounter for treatment of primary site (page 33)
Admission/Encounter for treatment of secondary site (page 33)
Coding and sequencing of complications (page 34)
Primary malignancy previously excised (page 34)
Admissions/Encounters involving antineoplastic chemotherapy, immunotherapy and radiation therapy (page 35)
Admission/encounter to determine extent of malignancy (page 36)
Symptoms, signs, and abnormal findings listed in Chapter 18 associated with neoplasms (page 36)
Admission/encounter for pain control/management (page 36)

Read Section I.C.2 (page 32), 12 more topics

All codes under C95

C95 can't be used on a claim. Pick a billable code below; grey headings group them.

C95 MS-DRGs

As the principal diagnosis, the billable codes under C95 group to these 24 MS-DRGs (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.

DRG 820 Lymphoma and Leukemia with Major O.R. Procedures with MCC (9 of 9 codes)
DRG 821 Lymphoma and Leukemia with Major O.R. Procedures with CC (9 of 9 codes)
DRG 822 Lymphoma and Leukemia with Major O.R. Procedures without CC/MCC (9 of 9 codes)
DRG 823 Lymphoma and Non-Acute Leukemia with Other Procedures with MCC (6 of 9 codes)
DRG 824 Lymphoma and Non-Acute Leukemia with Other Procedures with CC (6 of 9 codes)
DRG 825 Lymphoma and Non-Acute Leukemia with Other Procedures without CC/MCC (6 of 9 codes)
DRG 840 Lymphoma and Non-Acute Leukemia with MCC (6 of 9 codes)
DRG 841 Lymphoma and Non-Acute Leukemia with CC (6 of 9 codes)
DRG 842 Lymphoma and Non-Acute Leukemia without CC/MCC (6 of 9 codes)
DRG 834 Acute Leukemia with MCC (3 of 9 codes)
DRG 835 Acute Leukemia with CC (3 of 9 codes)
DRG 836 Acute Leukemia without CC/MCC (3 of 9 codes)
DRG 837 Chemotherapy with Acute Leukemia as Secondary Diagnosis or with High Dose Chemotherapy Agent with MCC (3 of 9 codes)
DRG 838 Chemotherapy with Acute Leukemia as Secondary Diagnosis with CC or High Dose Chemotherapy Agent (3 of 9 codes)
DRG 839 Chemotherapy with Acute Leukemia as Secondary Diagnosis without CC/MCC (3 of 9 codes)
DRG 850 Acute Leukemia with Other Procedures (3 of 9 codes)
DRG 826 Myeloproliferative Disorders or Poorly Differentiated Neoplasms with Major O.R. Procedures with MCC (1 of 9 codes)
DRG 827 Myeloproliferative Disorders or Poorly Differentiated Neoplasms with Major O.R. Procedures with CC (1 of 9 codes)
DRG 828 Myeloproliferative Disorders or Poorly Differentiated Neoplasms with Major O.R. Procedures without CC/MCC (1 of 9 codes)
DRG 829 Myeloproliferative Disorders or Poorly Differentiated Neoplasms with Other Procedures with CC/MCC (1 of 9 codes)
DRG 830 Myeloproliferative Disorders or Poorly Differentiated Neoplasms with Other Procedures without CC/MCC (1 of 9 codes)
DRG 843 Other Myeloproliferative Disorders or Poorly Differentiated Neoplastic Diagnoses with MCC (1 of 9 codes)
DRG 844 Other Myeloproliferative Disorders or Poorly Differentiated Neoplastic Diagnoses with CC (1 of 9 codes)
DRG 845 Other Myeloproliferative Disorders or Poorly Differentiated Neoplastic Diagnoses without CC/MCC (1 of 9 codes)

Other codes that refer to C95

Notes on these codes point to C95.

D72.8 Excludes1: leukemia (C91-C95)
D72.825 Excludes1: leukemia (C91.-, C92.-, C93.-, C94.-, C95.-)
M36.1 Code First: leukemia (C91-C95)
N16 Code First: leukemia (C91-C95)
R50.81 Code First: leukemia (C91-C95)
T66 Excludes1: leukemia (C91-C95)
Z80.6 Includes: Conditions classifiable to C91-C95
Z85.6 Includes: Conditions classifiable to C91-C95

About the condition

Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.

Leukemia

Leukemia is a term for cancers of the blood cells. Leukemia starts in blood-forming tissues such as the bone marrow. Your bone marrow makes the cells which will develop into white blood cells, red blood cells, and platelets. Each type of cell has a different job:

Code history

Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.