2025 ICD-10-CM code C84.7
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Malignant Neoplasms - Malignant neoplasms of lymphoid, hematopoietic and related tissue Chapter 2: Neoplasms (C00-D49) Feed
Anaplastic large cell lymphoma, ALK-negative.
Modifiers may be applicable depending on the circumstances of service.Consult the appropriate modifier guidelines for the specific payer and service(s) provided.
Medical necessity for treatment of ALK-negative ALCL is established based on the diagnosis of the malignant lymphoma and the need for intervention to control the disease and improve the patient's prognosis.Documentation must support the diagnosis, stage, and the appropriateness of the treatment plan based on established clinical guidelines.
The clinical responsibility involves diagnosing the condition through history, physical examination, and diagnostic testing (biopsy, CBC, LDH, imaging studies); staging the disease; determining the appropriate treatment plan (chemotherapy, radiation, surgery, stem cell transplant); and monitoring the patient's response to treatment. The physician's involvement also includes appropriate referrals, counseling, and providing ongoing support to the patient and their family.
- Chapter 2: Neoplasms (C00-D49)
- C81-C96 Malignant neoplasms, stated or presumed to be primary, of lymphoid, hematopoietic and related tissue
In simple words: ALK-negative anaplastic large cell lymphoma is a rare and fast-growing type of cancer affecting the lymph nodes and other parts of the body.It's diagnosed through tests like biopsies and blood work and is usually treated with chemotherapy.
Anaplastic large cell lymphoma (ALCL), ALK-negative, is a rare, aggressive T-cell non-Hodgkin lymphoma characterized by the absence of anaplastic lymphoma kinase (ALK) protein expression.It presents with painless lymph node masses, fever, fatigue, and other systemic symptoms. Diagnosis involves lymph node biopsy, microscopic examination, complete blood count (CBC), lactate dehydrogenase (LDH) levels, and imaging studies (CT, MRI, PET). Treatment typically includes chemotherapy, potentially followed by stem cell transplantation.Localized cutaneous disease may be managed with radiation therapy or surgery.
Example 1: A 60-year-old male presents with painless swelling in the left axillary lymph nodes. Biopsy reveals ALK-negative ALCL.The patient undergoes chemotherapy., A 72-year-old female is diagnosed with localized cutaneous ALK-negative ALCL.The lesion is surgically excised., A 55-year-old male with widespread ALK-negative ALCL receives chemotherapy followed by autologous stem cell transplantation.
Detailed pathology report confirming the diagnosis of ALK-negative ALCL, including immunohistochemical staining results.Complete blood count (CBC), lactate dehydrogenase (LDH) levels, and other relevant lab results.Imaging studies (CT, MRI, PET) to determine the extent of disease.Documentation of the treatment plan, including chemotherapy regimens, surgical procedures, or radiation therapy details.Progress notes detailing the patient's response to treatment.
** Additional information may be required depending on the specific payer and the complexity of the case.Always refer to payer-specific guidelines and medical necessity criteria for proper coding and billing practices.
- Revenue Code: Revenue codes will vary depending on the specific services provided and the payer.Consult the appropriate revenue code guidelines for the specific payer.
- RVU: RVUs are not directly provided in the source data and will vary by geographical location, payer, and other factors.Consult the relevant fee schedules for more information.
- Global Days: The global period will depend on the specific procedures performed. Consult CPT guidelines or the payer's fee schedule for details.
- Payment Status: Active (as of 03 December 2024)
- Modifier TC rule: The applicability of TC modifiers will depend on whether the service is a technical component or a professional component.Consult CPT guidelines for details on component modifiers.
- Fee Schedule: Historical fee schedule data is not provided in the source. Consult payer-specific fee schedules and historical data for reimbursement information.
- Specialties:Hematology, Oncology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Office