Common ICD-10 Codes for Testing Local Coverage Determination Flow Cytometry ID L35032

Complete the 5-digit codes with a 5th digit Complete the 5-digit /Myeloma codes with a 5th digit Unspecified site ...... 0 Not having achieved remission ...... 0 Lymph nodes of head, face and neck ...... 1 In remission ...... 1 Intrathoracic lymph nodes ...... 2 In relapse ...... 2 Intra-abdominal lymph nodes ...... 3 Lymph nodes of axilla and upper limb ...... 4 Multiple myeloma and malignant plasma cell Lymph nodes of inguinal region and lower limb ...... 5 Multiple myeloma ...... C90.0_ Intrapelvic lymph nodes ...... 6 ...... C90.1_ Spleen ...... 7 Extramedullary ...... C90.2_ Lymph nodes of multiple sites ...... 8 Solitary plasmacytoma ...... C90.3_ Extranodal and solid organ sites ...... 9 Acute lymphoblastic leukemia [ALL] ...... C91.0_ Nodular predominant Hodgkin lymphoma ...... C81.0_ Chronic lymphocytic leukemia of B-cell type ...... C91.1_ Hodgkin lymphoma ...... C81.1_ Prolymphocytic leukemia of B-cell type ...... C91.3_ Mixed cellularity Hodgkin lymphoma ...... C81.2_ ...... C91.4_ Lymphocyte depleted Hodgkin lymphoma ...... C81.3_ Adult T-cell lymphoma/leukemia (HTLV-1-associated) ...... C91.5_ Lymphocyte-rich Hodgkin lymphoma ...... C81.4_ Prolymphocytic leukemia of T-cell type...... C91.6_ Other Hodgkin lymphoma ...... C81.7_ Lymphoid leukemia, unspecified ...... C91.9_ Hodgkin lymphoma, unspecified ...... C81.9_ Mature B-cell leukemia Burkitt-type ...... C91.A_ Other lymphoid leukemia ...... C91.Z_ Follicular lymphoma grade I ...... C82.0_ Follicular lymphoma grade II ...... C82.1_ Acute myeloblastic leukemia ...... C92.0_ Follicular lymphoma grade III, unspecified ...... C82.2_ Chronic myeloid leukemia, BCR/ABL-positive ...... C92.1_ Follicular lymphoma grade IIIa ...... C82.3_ Atypical chronic myeloid leukemia, BCR/ABL-negative ...... C92.2_ Follicular lymphoma grade IIIb ...... C82.4_ ...... C92.3_ Diffuse follicle center lymphoma...... C82.5_ Acute promyelocytic leukemia ...... C92.4_ Cutaneous follicle center lymphoma ...... C82.6_ Acute myelomonocytic leukemia ...... C92.5_ Other types of follicular lymphoma ...... C82.8_ with 11q23-abnormality ...... C92.6_ Follicular lymphoma, unspecified ...... C82.9_ Myeloid leukemia, unspecified ...... C92.9_ Acute myeloid leukemia with multilineage dysplasia ...... C92.A_ Non-follicular lymphoma Other myeloid leukemia ...... C92.Z_ Small cell B-cell lymphoma ...... C83.0_ ...... C83.1_ Monocytic leukemia Diffuse large B-cell lymphoma ...... C83.3_ Acute monoblastic/monocytic leukemia ...... C93.0_ Lymphoblastic (diffuse) lymphoma ...... C83.5_ Chronic myelomonocytic leukemia ...... C93.1_ ...... C83.7_ Juvenile myelomonocytic leukemia ...... C93.3_ Other non-follicular lymphoma...... C83.8_ Monocytic leukemia, unspecified ...... C93.9_ Non-follicular (diffuse) lymphoma, unspecified...... C83.9_ Other monocytic leukemia ...... C93.Z_

Mature T/NK-cell Other of specified cell type ...... C84.0_ Acute erythroid leukemia ...... C94.0_ Sézary disease ...... C84.1_ Acute megakaryoblastic leukemia ...... C94.2_ Peripheral T-cell lymphoma, not classified ...... C84.4_ ...... C94.3_ Anaplastic large cell lymphoma, ALK-positive ...... C84.6_ Acute panmyelosis with myelofibrosis ...... C94.4_ Anaplastic large cell lymphoma, ALK-negative ...... C84.7_ Myelodysplastic disease, not classified ...... C94.6 Mature T/NK-cell lymphomas, unspecified ...... C84.9_ Other specified leukemias...... C94.8_ Cutaneous T-cell lymphoma, unspecified ...... C84.A_ Other mature T/NK-cell lymphomas ...... C84.Z_ Leukemia of unspecified cell type Acute leukemia of unspecified cell type ...... C95.0_ Other specified and unspecified types of non-Hodgkin lymphoma Chronic leukemia of unspecified cell type ...... C95.1_ Unspecified B-cell lymphoma ...... C85.1_ Leukemia, unspecified...... C95.9_ Mediastinal (thymic) large B-cell lymphoma ...... C85.2_ Other specified types of non-Hodgkin lymphoma ...... C85.8_ Other and unspecified malignant neoplasms of lymphoid, Non-Hodgkin lymphoma, unspecified...... C85.9_ hematopoietic and related tissue Multifocal and multisystemic (disseminated) Langerhans-cell Malignant immunoproliferative diseases and certain other ...... C96.0 B-cell lymphomas Malignant mast cell , unspecified ...... C96.20 Waldenström macroglobulinemia ...... C88.0 ...... C96.22 Extranodal marginal zone B-cell lymphoma of mucosa-associated Other malignant mast cell neoplasm ...... C96.29 lymphoid tissue [MALT-lymphoma] ...... C88.4 Sarcoma of dendritic cells (accessory cells) ...... C96.4 Malignant neoplasm of ovary Other and unspecified Malignant neoplasm of right ovary ...... C56.1 in neoplastic disease ...... D63.0 Malignant neoplasm of left ovary ...... C56.2 Hereditary sidertoblastic anemia ...... D64.0 Malignant neoplasm of unspecified ovary ...... C56.9 Congenital dyserythropoietic anemia ...... D64.4 Other specified anemias ...... D64.89 Malignant neoplasm of breast of unspecified site Anemia, unspecified ...... D64.9 Unspecified site of right female breast ...... C50.911 Unspecified site of left female breast ...... C50.912 Purpura and other hemorrhagic conditions Unspecified site of unspecified female breast ...... C50.919 Immune thrombocytopenic purpura ...... D69.3 Unspecified site of right male breast ...... C50.921 Evans syndrome ...... D69.41 Unspecified site of left male breast...... C50.922 Congenital and hereditary thrombocytopenia purpura ...... D69.42 Unspecified site of unspecified male breast ...... C50.929 Other primary thrombocytopenia ...... D69.49 Thrombocytopenia, unspecified ...... D69.6 Chronic myeloproliferative neoplasms ...... D45 Acquired pure red cell aplasia [erythroblastopenia] Essential (hemorrhagic) thrombocythemia ...... D47.3 Chronic acquired pure red cell aplasia ...... D60.0 Myelofibrosis ...... D75.81 Transient acquired pure red cell aplasia ...... D60.1 Chronic myeloid leukemia, BCR/ABL-positive (see front for 5th digit).. C92.1_ Other acquired pure red cell aplasias ...... D60.8 Other specified neoplasms of uncertain behavior of lymphoid, Acquired pure red cell aplasia, unspecified ...... D60.9 hematopoietic and related tissue ...... D47.Z9 Neutropenia and other disorders of white blood cells Myelodysplastic syndromes Congenital agranulocytosis ...... D70.0 Refractory anemia without ring sideroblasts, so stated ...... D46.0 Agranulocytosis secondary to cancer chemotherapy ...... D70.1 Refractory anemia with ring sideroblasts ...... D46.1 Other drug-induced agranulocytosis ...... D70.2 Refractory anemia with excess of blasts, unspecified ...... D46.20 Neutropenia due to infection ...... D70.3 Refractory anemia with excess of blasts (RAEB)-1 ...... D46.21 Cyclic neutropenia ...... D70.4 Refractory anemia with excess of blasts (RAEB)-2 ...... D46.22 Other neutropenia ...... D70.8 Refractory anemia, unspecified ...... D46.4 Neutropenia, unspecified...... D70.9 , unspecified ...... D46.9 Functional disorders of polymorphonuclear ...... D71 Refractory cytopenia with multilineage dysplasia ...... D46.A Genetic anomalies of leukocytes ...... D72.0 Refractory cytopenia with multilineage dysplasia and Eosinophilia ...... D72.1 ring sideroblasts ...... D46.B Lymphocytopenia ...... D72.810 Myelodysplastic syndrome with isolated del(5q) Other decreased count ...... D72.818 chromosomal abnormality ...... D46.C Decreased white blood cell count, unspecified ...... D72.819 Other myelodysplastic syndromes ...... D46.Z (symptomatic) ...... D72.820 Chronic myeloproliferative disease ...... D47.1 (symptomatic) ...... D72.821 Neoplasm of uncertain behavior of lymphoid, hematopoietic and Plasmacytosis ...... D72.822 related tissue, unspecified...... D47.9 ...... D72.823 Post-transplant lymphoproliferative disorder (PTLD) ...... D47.Z1 ...... D72.824 Other specified neoplasms of uncertain behavior of lymphoid, Other elevated white blood cell count ...... D72.828 hematopoietic and related tissue...... D47.Z9 Elevated white blood cell count, unspecified ...... D72.829 Other specified disorders of white blood cells ...... D72.89 Disorders of plasma protein metabolism Disorder of white blood cells, unspecified ...... D72.9 ...... D47.2 Cryoglobulinemia ...... D89.1 Sickle-cell disorders Hypergammaglobulinemia, unspecified ...... D89.2 Hb-SS disease with splenic sequestration ...... D57.02 Waldenström macroglobulinemia ...... C88.0 Sickle-cell/Hb-C disease with splenic sequestration ...... D57.212 Other disorders of plasma-protein metabolism, not elsewhere classified. E88.09 Sickle-cell thalassemia with splenic sequestration ...... D57.412 Other hemoglobinopathies ...... D58.2 Other aplastic anemias and other failure syndromes Other and unspecified diseases of blood and Drug-induced aplastic anemia ...... D61.1 blood-forming organs Aplastic anemia due to other external agents ...... D61.2 Myelofibrosis ...... D75.81 Idiopathic aplastic anemia ...... D61.3 Disease of blood and blood-forming organs, unspecified ...... D75.9 Antineoplastic chemotherapy induced pancytopenia ...... D61.810 Other drug-induced pancytopenia ...... D61.811 Symptoms, signs and abnormal clinical and laboratory findings, Other pancytopenia ...... D61.818 not elsewhere classified Myelophthisis ...... D61.82 Splenomegaly, not elsewhere classified...... R16.1 Other specified aplastic anemias and other bone marrow Localized enlarged lymph nodes ...... R59.0 failure syndromes ...... D61.89 Generalized enlarged lymph nodes ...... R59.1 Aplastic anemia, unspecified ...... D61.9 Enlarged lymph nodes, unspecified ...... R59.9

This list is subject to change and is not all-inclusive. CP–FY–0010–v1–1217

Please refer to the most current version of the Coding Manual of the American Medical Association (AMA) for a complete list of ICD-10 codes. Information has been obtained through the Centers for Medicare and Medicaid Services (CMS) and Local Coverage Determination for Flow Cytometry. Codes listed are effective as of October 1, 2017.