2025 ICD-10-CM code C85.90
(Active) Effective Date: N/A Revision Date: N/A Malignant neoplasms - Non-Hodgkin lymphoma, unspecified Chapter 2: Neoplasms Feed
This code represents unspecified Non-Hodgkin lymphoma without specification of the affected site.
Modifiers might be applicable depending on the specific services provided and the payer's requirements.Consult payer-specific guidelines for more information.
Medical necessity for the assignment of this code is established by the presence of clinical findings suggestive of lymphoma, necessitating further investigation and potentially treatment.The documentation must clearly support the diagnosis and justify any interventions undertaken.
The clinical responsibility includes diagnosing the lymphoma through history, physical examination, imaging studies (such as CT or PET scans), lymph node biopsy, and laboratory tests (like CBC, LDH, kidney function tests, and liver function tests). Treatment decisions are based on the stage and severity of the disease and may involve watchful waiting, radiation therapy, chemotherapy (single agent or multiple agents), or a combination of treatments. Regular follow-up is essential.
In simple words: This code is for Non-Hodgkin lymphoma when doctors don't know the exact type or where it's located in the body.
C85.90 in the ICD-10-CM classification system designates Non-Hodgkin lymphoma, where neither the specific type of lymphoma nor the precise location is specified.This code is used when the available clinical information is insufficient to assign a more specific code.It encompasses a broad range of B-cell and T-cell lymphomas.
Example 1: A 60-year-old male presents with generalized lymphadenopathy.Biopsy reveals a Non-Hodgkin lymphoma, but further testing is inconclusive regarding the specific type and precise location. C85.90 is assigned., A 72-year-old female undergoes a routine checkup and blood work reveals abnormalities suggestive of lymphoma. Imaging studies show widespread lymphadenopathy, but the tissue biopsy is insufficient to pinpoint the type.C85.90 is coded., A 45-year-old patient with a history of autoimmune disease is experiencing fatigue and night sweats. Blood work and imaging suggest a lymphoma, but additional tests needed for subtype identification are delayed. C85.90 is temporarily assigned, pending results.
Complete medical history including presenting symptoms, physical examination findings, laboratory results (CBC, LDH, kidney and liver function tests), imaging reports (CT or PET scans), and pathology reports from lymph node biopsies. If available, details of the specific lymphoma subtype and site of involvement.Documentation of treatment plan (e.g.watchful waiting, chemotherapy regimen) and response to treatment.
** This code is often a placeholder until more specific information becomes available, facilitating ongoing claim processing and treatment management. When additional information becomes available, the code should be updated to reflect the most precise diagnosis.
- Payment Status: Active
- Specialties:Hematology, Oncology
- Place of Service:Office, Hospital Inpatient, Hospital Outpatient, Ambulatory Surgical Center