2025 ICD-10-CM code C94.30
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Malignant neoplasms - Mast cell leukemia Chapter 2: Neoplasms Feed
Mast cell leukemia without remission.
Medical necessity is established through the diagnosis of mast cell leukemia and the documentation supporting the severity and active nature of the disease.The absence of remission and ongoing symptoms indicate the need for treatment.
Diagnosis is based on patient history, physical examination, and laboratory tests including CBC, blood smear, bone marrow biopsy, flow cytometry, and potentially genetic testing. Treatment may involve chemotherapy, targeted therapy, interferon, stem cell transplant, radiation, and/or surgery depending on disease stage and patient factors.
- Chapter 2: Neoplasms
- C81-C96 (Malignant neoplasms of lymphoid, hematopoietic and related tissue); C94 (Other leukemias of specified cell type); C94.3 (Mast cell leukemia)
In simple words: This code means a person has a type of blood cancer called mast cell leukemia that hasn't gone into remission (meaning the cancer isn't under control yet).
This ICD-10-CM code, C94.30, specifies mast cell leukemia that has not achieved remission.Mast cell leukemia is a rare and aggressive form of acute myeloid leukemia (AML) characterized by the abnormal proliferation of mast cells in the peripheral blood.The diagnosis requires confirmation through various laboratory tests, including complete blood count (CBC), peripheral blood smear, bone marrow biopsy, flow cytometry, and potentially genetic analyses.The code is applied when the patient's condition is actively progressing and has not responded to treatment resulting in remission.
Example 1: A 60-year-old male presents with fatigue, weight loss, and splenomegaly.Laboratory tests reveal a high percentage of mast cells in the peripheral blood and bone marrow.The patient does not meet criteria for remission. Code C94.30 is assigned., A 55-year-old female with a history of mast cell leukemia undergoes chemotherapy. While there's some improvement in mast cell counts, it does not reach remission criteria. Code C94.30 is used to reflect the ongoing disease activity., A 72-year-old patient diagnosed with mast cell leukemia several years ago and who has shown no response to multiple treatment regimens, is currently experiencing increased symptoms. Code C94.30 is appropriate as the disease is not in remission.
Complete blood count (CBC), peripheral blood smear, bone marrow biopsy report with percentage of mast cells, flow cytometry results, and any relevant genetic testing results.Documentation should clearly indicate that the criteria for remission have not been met.
** This code should not be used if the patient's mast cell leukemia is in remission or relapse.The specific type of mast cell leukemia (e.g., systemic mastocytosis) may require additional codes.
- Payment Status: Active
- Specialties:Hematology, Oncology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Physician's Office