LCD/NCD Portal
Automated World Health
L31247 FLOW CYTOMETRY
09/30/2010
Indications and Limitations of Coverage and/or Medical Necessity
Indications
First Coast Service Options, Inc. (FSCO) will consider Flow cytometry for cell surface cytoplasmic or nuclear marker medically reasonable and necessary when performed for the following indications:
• Cytopenias and Hypercellular Hematolymphoid Disorder.
• Lymphomas.
• Acute Leukemia.
• Chronic Lymphocytic Leukemia (CLL) & Other Chronic Lymphoproliferative Diseases (CLPD).
• Plasma Cell Disorders.
• Myelodysplastic Syndromes (MDS).
• Chronic Myeloproliferative Disorders (CMPD).
• Mast Cell Neoplasms.
• Paroxysmal Nocturnal Hemoglobinuria (PNH).
• Minimal Residual Disease (MRD).
• HIV Infection.
• Organ Transplants.
• DNA Analysis.
• Carcinoma, Non-hematolymphoid Tumors.
• Molar Pregnancy.
• Primary Immunodeficiencies (PDS).
• Primary Platelet Disorders, Non-neoplastic.
• Red Cell and White Cell Disorders, Non-neoplastic.
FSCOs will consider flow cytometry-derived DNA content (ploidy), or cell proliferative activity (S-phase fraction), medically reasonable and necessary when performed for the following localized neoplasms:
• Mediastinum.
• Uterus.
• Ovary.
• Prostate.
• Bladder.
• Kidney/renal.
• Brain.
• Gastric.
• Breast.
• Colon.
• Rectal.
• Hydatidiform mole.
Limitations
• FCM immunophenotypes for most common lymphomas and leukemias are well characterized.
o FCSO Medicare does NOT consider it medically reasonable and necessary to perform more than twenty-four (24) markers in a panel.
o When atypical or unusual FCM results are obtained and the selective addition of more markers is indicated, the flow report must document the specific indication for each marker over the twenty-four (24) limit.
o Any markers in excess of twenty-four (24) must be supported by documentation which clearly states the justification for the need for excess markers.
• Flow cytometry cell cycle or DNA analysis (CPT code 88182) is indicated for a few selective groups of patients with certain carcinomas.
o Information obtained from flow cytometry is useful when the prognostic information will affect treatment decisions in patients with localized disease.
o It is usually performed one time after a diagnosis has been made and before treatment is initiated
CPT/HCPCS Codes
88182 FLOW CYTOMETRY, CELL CYCLE OR DNA ANALYSIS
88184 FLOW CYTOMETRY, CELL SURFACE, CYTOPLASMIC, OR NUCLEAR MARKER, TECHNICAL COMPONENT ONLY; FIRST MARKER
88185 FLOW CYTOMETRY, CELL SURFACE, CYTOPLASMIC, OR NUCLEAR MARKER, TECHNICAL COMPONENT ONLY; EACH ADDITIONAL MARKER (LIST SEPARATELY IN ADDITION TO CODE FOR FIRST MARKER)
88187 FLOW CYTOMETRY, INTERPRETATION; 2 TO 8 MARKERS
88188 FLOW CYTOMETRY, INTERPRETATION; 9 TO 15 MARKERS
88189 FLOW CYTOMETRY, INTERPRETATION; 16 OR MORE MARKERS
ICD-9 Codes that Support Medical Necessity
USE FOR BILLING CPT CODE 88182
151.0 MALIGNANT NEOPLASM OF CARDIA
151.1 MALIGNANT NEOPLASM OF PYLORUS
151.2 MALIGNANT NEOPLASM OF PYLORIC ANTRUM
151.3 MALIGNANT NEOPLASM OF FUNDUS OF STOMACH
151.4 MALIGNANT NEOPLASM OF BODY OF STOMACH
151.5 MALIGNANT NEOPLASM OF LESSER CURVATURE OF STOMACH UNSPECIFIED
151.6 MALIGNANT NEOPLASM OF GREATER CURVATURE OF STOMACH UNSPECIFIED
151.8 MALIGNANT NEOPLASM OF OTHER SPECIFIED SITES OF STOMACH
151.9 MALIGNANT NEOPLASM OF STOMACH UNSPECIFIED SITE
153.0 MALIGNANT NEOPLASM OF HEPATIC FLEXURE
153.1 MALIGNANT NEOPLASM OF TRANSVERSE COLON
153.2 MALIGNANT NEOPLASM OF DESCENDING COLON
153.3 MALIGNANT NEOPLASM OF SIGMOID COLON
153.4 MALIGNANT NEOPLASM OF CECUM
153.5 MALIGNANT NEOPLASM OF APPENDIX VERMIFORMIS
153.6 MALIGNANT NEOPLASM OF ASCENDING COLON
153.7 MALIGNANT NEOPLASM OF SPLENIC FLEXURE
153.8 MALIGNANT NEOPLASM OF OTHER SPECIFIED SITES OF LARGE INTESTINE
153.9 MALIGNANT NEOPLASM OF COLON UNSPECIFIED SITE
154.1 MALIGNANT NEOPLASM OF RECTUM
164.2 MALIGNANT NEOPLASM OF ANTERIOR MEDIASTINUM
164.3 MALIGNANT NEOPLASM OF POSTERIOR MEDIASTINUM
174.0 MALIGNANT NEOPLASM OF NIPPLE AND AREOLA OF FEMALE BREAST
174.1 MALIGNANT NEOPLASM OF CENTRAL PORTION OF FEMALE BREAST
174.2 MALIGNANT NEOPLASM OF UPPER-INNER QUADRANT OF FEMALE BREAST
174.3 MALIGNANT NEOPLASM OF LOWER-INNER QUADRANT OF FEMALE BREAST
174.4 MALIGNANT NEOPLASM OF UPPER-OUTER QUADRANT OF FEMALE BREAST
174.5 MALIGNANT NEOPLASM OF LOWER-OUTER QUADRANT OF FEMALE BREAST
174.6 MALIGNANT NEOPLASM OF AXILLARY TAIL OF FEMALE BREAST
174.8 MALIGNANT NEOPLASM OF OTHER SPECIFIED SITES OF FEMALE BREAST
174.9 MALIGNANT NEOPLASM OF BREAST (FEMALE) UNSPECIFIED SITE
175.0 MALIGNANT NEOPLASM OF NIPPLE AND AREOLA OF MALE BREAST
175.9 MALIGNANT NEOPLASM OF OTHER AND UNSPECIFIED SITES OF MALE BREAST
182.0 MALIGNANT NEOPLASM OF CORPUS UTERI EXCEPT ISTHMUS
183.0 MALIGNANT NEOPLASM OF OVARY
183.8 MALIGNANT NEOPLASM OF OTHER SPECIFIED SITES OF UTERINE ADNEXA
185 MALIGNANT NEOPLASM OF PROSTATE
188.0 MALIGNANT NEOPLASM OF TRIGONE OF URINARY BLADDER
188.1 MALIGNANT NEOPLASM OF DOME OF URINARY BLADDER
188.2 MALIGNANT NEOPLASM OF LATERAL WALL OF URINARY BLADDER
188.3 MALIGNANT NEOPLASM OF ANTERIOR WALL OF URINARY BLADDER
188.4 MALIGNANT NEOPLASM OF POSTERIOR WALL OF URINARY BLADDER
188.5 MALIGNANT NEOPLASM OF BLADDER NECK
188.6 MALIGNANT NEOPLASM OF URETERIC ORIFICE
188.7 MALIGNANT NEOPLASM OF URACHUS
188.8 MALIGNANT NEOPLASM OF OTHER SPECIFIED SITES OF BLADDER
189.0 MALIGNANT NEOPLASM OF KIDNEY EXCEPT PELVIS
189.1 MALIGNANT NEOPLASM OF RENAL PELVIS
191.0 MALIGNANT NEOPLASM OF CEREBRUM EXCEPT LOBES AND VENTRICLES
191.1 MALIGNANT NEOPLASM OF FRONTAL LOBE
191.2 MALIGNANT NEOPLASM OF TEMPORAL LOBE
191.3 MALIGNANT NEOPLASM OF PARIETAL LOBE
191.4 MALIGNANT NEOPLASM OF OCCIPITAL LOBE
191.5 MALIGNANT NEOPLASM OF VENTRICLES
191.6 MALIGNANT NEOPLASM OF CEREBELLUM NOS
191.7 MALIGNANT NEOPLASM OF BRAIN STEM
191.8 MALIGNANT NEOPLASM OF OTHER PARTS OF BRAIN
191.9 MALIGNANT NEOPLASM OF BRAIN UNSPECIFIED SITE
630 HYDATIDIFORM MOLE
USE FOR BILLING CPT CODES 88184, 88185, 88187, 88188, AND 88189
042 HUMAN IMMUNODEFICIENCY VIRUS (HIV) DISEASE
079.51 HUMAN T-CELL LYMPHOTROPHIC VIRUS TYPE I [HTLV-I]
079.52 HUMAN T-CELL LYMPHOTROPHIC VIRUS TYPE II [HTLV-II]
079.53 HUMAN IMMUNODEFICIENCY VIRUS TYPE 2 [HIV-2]
099.3 REITER'S DISEASE
150.0 MALIGNANT NEOPLASM OF CERVICAL ESOPHAGUS
150.1 MALIGNANT NEOPLASM OF THORACIC ESOPHAGUS
150.2 MALIGNANT NEOPLASM OF ABDOMINAL ESOPHAGUS
150.3 MALIGNANT NEOPLASM OF UPPER THIRD OF ESOPHAGUS
150.4 MALIGNANT NEOPLASM OF MIDDLE THIRD OF ESOPHAGUS
150.5 MALIGNANT NEOPLASM OF LOWER THIRD OF ESOPHAGUS
150.8 MALIGNANT NEOPLASM OF OTHER SPECIFIED PART OF ESOPHAGUS
150.9 MALIGNANT NEOPLASM OF ESOPHAGUS UNSPECIFIED SITE
151.0 MALIGNANT NEOPLASM OF CARDIA
151.1 MALIGNANT NEOPLASM OF PYLORUS
151.2 MALIGNANT NEOPLASM OF PYLORIC ANTRUM
151.3 MALIGNANT NEOPLASM OF FUNDUS OF STOMACH
151.4 MALIGNANT NEOPLASM OF BODY OF STOMACH
151.5 MALIGNANT NEOPLASM OF LESSER CURVATURE OF STOMACH UNSPECIFIED
151.6 MALIGNANT NEOPLASM OF GREATER CURVATURE OF STOMACH UNSPECIFIED
151.8 MALIGNANT NEOPLASM OF OTHER SPECIFIED SITES OF STOMACH
151.9 MALIGNANT NEOPLASM OF STOMACH UNSPECIFIED SITE
153.0 MALIGNANT NEOPLASM OF HEPATIC FLEXURE
153.1 MALIGNANT NEOPLASM OF TRANSVERSE COLON
153.2 MALIGNANT NEOPLASM OF DESCENDING COLON
153.3 MALIGNANT NEOPLASM OF SIGMOID COLON
153.4 MALIGNANT NEOPLASM OF CECUM
153.5 MALIGNANT NEOPLASM OF APPENDIX VERMIFORMIS
153.6 MALIGNANT NEOPLASM OF ASCENDING COLON
153.7 MALIGNANT NEOPLASM OF SPLENIC FLEXURE
153.8 MALIGNANT NEOPLASM OF OTHER SPECIFIED SITES OF LARGE INTESTINE
153.9 MALIGNANT NEOPLASM OF COLON UNSPECIFIED SITE
154.0 MALIGNANT NEOPLASM OF RECTOSIGMOID JUNCTION
154.1 MALIGNANT NEOPLASM OF RECTUM
174.0 MALIGNANT NEOPLASM OF NIPPLE AND AREOLA OF FEMALE BREAST
174.1 MALIGNANT NEOPLASM OF CENTRAL PORTION OF FEMALE BREAST
174.2 MALIGNANT NEOPLASM OF UPPER-INNER QUADRANT OF FEMALE BREAST
174.3 MALIGNANT NEOPLASM OF LOWER-INNER QUADRANT OF FEMALE BREAST
174.4 MALIGNANT NEOPLASM OF UPPER-OUTER QUADRANT OF FEMALE BREAST
174.5 MALIGNANT NEOPLASM OF LOWER-OUTER QUADRANT OF FEMALE BREAST
174.6 MALIGNANT NEOPLASM OF AXILLARY TAIL OF FEMALE BREAST
174.8 MALIGNANT NEOPLASM OF OTHER SPECIFIED SITES OF FEMALE BREAST
174.9 MALIGNANT NEOPLASM OF BREAST (FEMALE) UNSPECIFIED SITE
175.0 MALIGNANT NEOPLASM OF NIPPLE AND AREOLA OF MALE BREAST
175.9 MALIGNANT NEOPLASM OF OTHER AND UNSPECIFIED SITES OF MALE BREAST
183.0 MALIGNANT NEOPLASM OF OVARY
183.8 MALIGNANT NEOPLASM OF OTHER SPECIFIED SITES OF UTERINE ADNEXA
185 MALIGNANT NEOPLASM OF PROSTATE
188.0 MALIGNANT NEOPLASM OF TRIGONE OF URINARY BLADDER
188.1 MALIGNANT NEOPLASM OF DOME OF URINARY BLADDER
188.2 MALIGNANT NEOPLASM OF LATERAL WALL OF URINARY BLADDER
188.3 MALIGNANT NEOPLASM OF ANTERIOR WALL OF URINARY BLADDER
188.4 MALIGNANT NEOPLASM OF POSTERIOR WALL OF URINARY BLADDER
188.5 MALIGNANT NEOPLASM OF BLADDER NECK
188.6 MALIGNANT NEOPLASM OF URETERIC ORIFICE
188.7 MALIGNANT NEOPLASM OF URACHUS
188.8 MALIGNANT NEOPLASM OF OTHER SPECIFIED SITES OF BLADDER
188.9 MALIGNANT NEOPLASM OF BLADDER PART UNSPECIFIED
193 MALIGNANT NEOPLASM OF THYROID GLAND
194.0 MALIGNANT NEOPLASM OF ADRENAL GLAND
197.2 SECONDARY MALIGNANT NEOPLASM OF PLEURA
197.6 SECONDARY MALIGNANT NEOPLASM OF RETROPERITONEUM AND PERITONEUM
200.00 RETICULOSARCOMA UNSPECIFIED SITE
200.01 RETICULOSARCOMA INVOLVING LYMPH NODES OF HEAD FACE AND NECK
200.02 RETICULOSARCOMA INVOLVING INTRATHORACIC LYMPH NODES
200.03 RETICULOSARCOMA INVOLVING INTRA-ABDOMINAL LYMPH NODES
200.04 RETICULOSARCOMA INVOLVING LYMPH NODES OF AXILLA AND UPPER LIMB
200.05 RETICULOSARCOMA INVOLVING LYMPH NODES OF INGUINAL REGION AND LOWER LIMB
200.06 RETICULOSARCOMA INVOLVING INTRAPELVIC LYMPH NODES
200.07 RETICULOSARCOMA INVOLVING SPLEEN
200.08 RETICULOSARCOMA INVOLVING LYMPH NODES OF MULTIPLE SITES
200.10 LYMPHOSARCOMA UNSPECIFIED SITE
200.11 LYMPHOSARCOMA INVOLVING LYMPH NODES OF HEAD FACE AND NECK
200.12 LYMPHOSARCOMA INVOLVING INTRATHORACIC LYMPH NODES
200.13 LYMPHOSARCOMA INVOLVING INTRA-ABDOMINAL LYMPH NODES
200.14 LYMPHOSARCOMA INVOLVING LYMPH NODES OF AXILLA AND UPPER LIMB
200.15 LYMPHOSARCOMA INVOLVING LYMPH NODES OF INGUINAL REGION AND LOWER LIMB
200.16 LYMPHOSARCOMA INVOLVING INTRAPELVIC LYMPH NODES
200.17 LYMPHOSARCOMA INVOLVING SPLEEN
200.18 LYMPHOSARCOMA INVOLVING LYMPH NODES OF MULTIPLE SITES
200.20 BURKITT'S TUMOR OR LYMPHOMA UNSPECIFIED SITE
200.21 BURKITT'S TUMOR OR LYMPHOMA INVOLVING LYMPH NODES OF HEAD FACE AND NECK
200.22 BURKITT'S TUMOR OR LYMPHOMA INVOLVING INTRATHORACIC LYMPH NODES
200.23 BURKITT'S TUMOR OR LYMPHOMA INVOLVING INTRA-ABDOMINAL LYMPH NODES
200.24 BURKITT'S TUMOR OR LYMPHOMA INVOLVING LYMPH NODES OF AXILLA AND UPPER LIMB
200.25 BURKITT'S TUMOR OR LYMPHOMA INVOLVING LYMPH NODES OF INGUINAL REGION AND LOWER LIMB
200.26 BURKITT'S TUMOR OR LYMPHOMA INVOLVING INTRAPELVIC LYMPH NODES
200.27 BURKITT'S TUMOR OR LYMPHOMA INVOLVING SPLEEN
200.28 BURKITT'S TUMOR OR LYMPHOMA INVOLVING LYMPH NODES OF MULTIPLE SITES
200.30 MARGINAL ZONE LYMPHOMA, UNSPECIFIED SITE, EXTRANODAL AND SOLID ORGAN SITES
200.31 MARGINAL ZONE LYMPHOMA,LYMPH NODES OF HEAD, FACE, AND NECK
200.32 MARGINAL ZONE LYMPHOMA,INTRATHORACIC LYMPH NODES
200.33 MARGINAL ZONE LYMPHOMA, INTRAABDOMINAL LYMPH NODES
200.34 MARGINAL ZONE LYMPHOMA, LYMPH NODES OF AXILLA AND UPPER LIMB
200.35 MARGINAL ZONE LYMPHOMA, LYMPH NODES OF INGUINAL REGION AND LOWER LIMB
200.36 MARGINAL ZONE LYMPHOMA, INTRAPELVIC LYMPH NODES
200.37 MARGINAL ZONE LYMPHOMA, SPLEEN
200.38 MARGINAL ZONE LYMPHOMA, LYMPH NODES OF MULTIPLE SITES
200.40 MANTLE CELL LYMPHOMA, UNSPECIFIED SITE, EXTRANODAL AND SOLID ORGAN SITES
200.41 MANTLE CELL LYMPHOMA, LYMPH NODES OF HEAD, FACE, AND NECK
200.42 MANTLE CELL LYMPHOMA, INTRATHORACIC LYMPH NODES
200.43 MANTLE CELL LYMPHOMA, INTRA-ABDOMINAL LYMPH NODES
200.44 MANTLE CELL LYMPHOMA, LYMPH NODES OF AXILLA AND UPPER LIMB
200.45 MANTLE CELL LYMPHOMA, LYMPH NODES OF INGUINAL REGION AND LOWER LIMB
200.46 MANTLE CELL LYMPHOMA, INTRAPELVIC LYMPH NODES
200.47 MANTLE CELL LYMPHOMA, SPLEEN
200.48 MANTLE CELL LYMPHOMA, LYMPH NODES OF MULTIPLE SITES
200.50 PRIMARY CENTRAL NERVOUS SYSTEM LYMPHOMA, UNSPECIFIED SITE, EXTRANODAL AND SOLID ORGAN SITES
200.51 PRIMARY CENTRAL NERVOUS SYSTEM LYMPHOMA, LYMPH NODES OF HEAD, FACE, AND NECK
200.52 PRIMARY CENTRAL NERVOUS SYSTEM LYMPHOMA, INTRATHORACIC LYMPH NODES
200.53 PRIMARY CENTRAL NERVOUS SYSTEM LYMPHOMA, INTRA-ABDOMINAL LYMPH NODES
200.54 PRIMARY CENTRAL NERVOUS SYSTEM LYMPHOMA, LYMPH NODES OF AXILLA AND UPPER LIMB
200.55 PRIMARY CENTRAL NERVOUS SYSTEM LYMPHOMA, LYMPH NODES OF INGUINAL REGION AND LOWER LIMB
200.56 PRIMARY CENTRAL NERVOUS SYSTEM LYMPHOMA, INTRAPELVIC LYMPH NODES
200.57 PRIMARY CENTRAL NERVOUS SYSTEM LYMPHOMA, SPLEEN
200.58 PRIMARY CENTRAL NERVOUS SYSTEM LYMPHOMA, LYMPH NODES OF MULTIPLE SITES
200.60 ANAPLASTIC LARGE CELL LYMPHOMA, UNSPECIFIED SITE, EXTRANODAL AND SOLID ORGAN SITES
200.61 ANAPLASTIC LARGE CELL LYMPHOMA, LYMPH NODES OF HEAD, FACE, AND NECK
200.62 ANAPLASTIC LARGE CELL LYMPHOMA, INTRATHORACIC LYMPH NODES
200.63 ANAPLASTIC LARGE CELL LYMPHOMA, INTRA-ABDOMINAL LYMPH NODES
200.64 ANAPLASTIC LARGE CELL LYMPHOMA, LYMPH NODES OF AXILLA AND UPPER LIMB
200.65 ANAPLASTIC LARGE CELL LYMPHOMA, LYMPH NODES OF INGUINAL REGION AND LOWER LIMB
200.66 ANAPLASTIC LARGE CELL LYMPHOMA, INTRAPELVIC LYMPH NODES
200.67 ANAPLASTIC LARGE CELL LYMPHOMA, SPLEEN
200.68 ANAPLASTIC LARGE CELL LYMPHOMA, LYMPH NODES OF MULTIPLE SITES
200.70 LARGE CELL LYMPHOMA, UNSPECIFIED SITE, EXTRANODAL AND SOLID ORGAN SITES
200.71 LARGE CELL LYMPHOMA, LYMPH NODES OF HEAD, FACE, AND NECK
200.72 LARGE CELL LYMPHOMA, INTRATHORACIC LYMPH NODES
200.73 LARGE CELL LYMPHOMA, INTRA-ABDOMINAL LYMPH NODES
200.74 LARGE CELL LYMPHOMA, LYMPH NODES OF AXILLA AND UPPER LIMB
200.75 LARGE CELL LYMPHOMA, LYMPH NODES OF INGUINAL REGION AND LOWER LIMB
200.76 LARGE CELL LYMPHOMA, INTRAPELVIC LYMPH NODES
200.77 LARGE CELL LYMPHOMA, SPLEEN
200.78 LARGE CELL LYMPHOMA, LYMPH NODES OF MULTIPLE SITES
200.80 OTHER NAMED VARIANTS OF LYMPHOSARCOMA AND RETICULOSARCOMA UNSPECIFIED SITE
200.81 OTHER NAMED VARIANTS OF LYMPHOSARCOMA AND RETICULOSARCOMA INVOLVING LYMPH NODES OF HEAD FACE AND NECK
200.82 OTHER NAMED VARIANTS OF LYMPHOSARCOMA AND RETICULOSARCOMA INVOLVING INTRATHORACIC LYMPH NODES
200.83 OTHER NAMED VARIANTS OF LYMPHOSARCOMA AND RETICULOSARCOMA INVOLVING INTRA-ABDOMINAL LYMPH NODES
200.84 OTHER NAMED VARIANTS OF LYMPHOSARCOMA AND RETICULOSARCOMA INVOLVING LYMPH NODES OF AXILLA AND UPPER LIMB
200.85 OTHER NAMED VARIANTS OF LYMPHOSARCOMA AND RETICULOSARCOMA INVOLVING LYMPH NODES OF INGUINAL REGION AND LOWER LIMB
200.86 OTHER NAMED VARIANTS OF LYMPHOSARCOMA AND RETICULOSARCOMA INVOLVING INTRAPELVIC LYMPH NODES
200.87 OTHER NAMED VARIANTS OF LYMPHOSARCOMA AND RETICULOSARCOMA INVOLVING SPLEEN
200.88 OTHER NAMED VARIANTS OF LYMPHOSARCOMA AND RETICULOSARCOMA INVOLVING LYMPH NODES OF MULTIPLE SITES
201.00 HODGKIN'S PARAGRANULOMA UNSPECIFIED SITE
201.01 HODGKIN'S PARAGRANULOMA INVOLVING LYMPH NODES OF HEAD FACE AND NECK
201.02 HODGKIN'S PARAGRANULOMA INVOLVING INTRATHORACIC LYMPH NODES
201.03 HODGKIN'S PARAGRANULOMA INVOLVING INTRA-ABDOMINAL LYMPH NODES
201.04 HODGKIN'S PARAGRANULOMA INVOLVING LYMPH NODES OF AXILLA AND UPPER LIMB
201.05 HODGKIN'S PARAGRANULOMA INVOLVING LYMPH NODES OF INGUINAL REGION AND LOWER LIMB
201.06 HODGKIN'S PARAGRANULOMA INVOLVING INTRAPELVIC LYMPH NODES
201.07 HODGKIN'S PARAGRANULOMA INVOLVING SPLEEN
201.08 HODGKIN'S PARAGRANULOMA INVOLVING LYMPH NODES OF MULTIPLE SITES
201.10 HODGKIN'S GRANULOMA UNSPECIFIED SITE
201.11 HODGKIN'S GRANULOMA INVOLVING LYMPH NODES OF HEAD FACE AND NECK
201.12 HODGKIN'S GRANULOMA INVOLVING INTRATHORACIC LYMPH NODES
201.13 HODGKIN'S GRANULOMA INVOLVING INTRA-ABDOMINAL LYMPH NODES
201.14 HODGKIN'S GRANULOMA INVOLVING LYMPH NODES OF AXILLA AND UPPER LIMB
201.15 HODGKIN'S GRANULOMA INVOLVING LYMPH NODES OF INGUINAL REGION AND LOWER LIMB
201.16 HODGKIN'S GRANULOMA INVOLVING INTRAPELVIC LYMPH NODES
201.17 HODGKIN'S GRANULOMA INVOLVING SPLEEN
201.18 HODGKIN'S GRANULOMA INVOLVING LYMPH NODES OF MULTIPLE SITES
201.20 HODGKIN'S SARCOMA UNSPECIFIED SITE
201.21 HODGKIN'S SARCOMA INVOLVING LYMPH NODES OF HEAD FACE AND NECK
201.22 HODGKIN'S SARCOMA INVOLVING INTRATHORACIC LYMPH NODES
201.23 HODGKIN'S SARCOMA INVOLVING INTRA-ABDOMINAL LYMPH NODES
201.24 HODGKIN'S SARCOMA INVOLVING LYMPH NODES OF AXILLA AND UPPER LIMB
201.25 HODGKIN'S SARCOMA INVOLVING LYMPH NODES OF INGUINAL REGION AND LOWER LIMB
201.26 HODGKIN'S SARCOMA INVOLVING INTRAPELVIC LYMPH NODES
201.27 HODGKIN'S SARCOMA INVOLVING SPLEEN
201.28 HODGKIN'S SARCOMA INVOLVING LYMPH NODES OF MULTIPLE SITES
201.40 HODGKIN'S DISEASE LYMPHOCYTIC-HISTIOCYTIC PREDOMINANCE UNSPECIFIED SITE
201.41 HODGKIN'S DISEASE LYMPHOCYTIC-HISTIOCYTIC PREDOMINANCE INVOLVING LYMPH NODES OF HEAD FACE AND NECK
201.42 HODGKIN'S DISEASE LYMPHOCYTIC-HISTIOCYTIC PREDOMINANCE INVOLVING INTRATHORACIC LYMPH NODES
201.43 HODGKIN'S DISEASE LYMPHOCYTIC-HISTIOCYTIC PREDOMINANCE INVOLVING INTRA-ABDOMINAL LYMPH NODES
201.44 HODGKIN'S DISEASE LYMPHOCYTIC-HISTIOCYTIC PREDOMINANCE INVOLVING LYMPH NODES OF AXILLA AND UPPER LIMB
201.45 HODGKIN'S DISEASE LYMPHOCYTIC-HISTIOCYTIC PREDOMINANCE INVOLVING LYMPH NODES OF INGUINAL REGION AND LOWER LIMB
201.46 HODGKIN'S DISEASE LYMPHOCYTIC-HISTIOCYTIC PREDOMINANCE INVOLVING INTRAPELVIC LYMPH NODES
201.47 HODGKIN'S DISEASE LYMPHOCYTIC-HISTIOCYTIC PREDOMINANCE INVOLVING SPLEEN
201.48 HODGKIN'S DISEASE LYMPHOCYTIC-HISTIOCYTIC PREDOMINANCE INVOLVING LYMPH NODES OF MULTIPLE SITES
201.50 HODGKIN'S DISEASE NODULAR SCLEROSIS UNSPECIFIED SITE
201.51 HODGKIN'S DISEASE NODULAR SCLEROSIS INVOLVING LYMPH NODES OF HEAD FACE AND NECK
201.52 HODGKIN'S DISEASE NODULAR SCLEROSIS INVOLVING INTRATHORACIC LYMPH NODES
201.53 HODGKIN'S DISEASE NODULAR SCLEROSIS INVOLVING INTRA-ABDOMINAL LYMPH NODES
201.54 HODGKIN'S DISEASE NODULAR SCLEROSIS INVOLVING LYMPH NODES OF AXILLA AND UPPER LIMB
201.55 HODGKIN'S DISEASE NODULAR SCLEROSIS INVOLVING LYMPH NODES OF INGUINAL REGION AND LOWER LIMB
201.56 HODGKIN'S DISEASE NODULAR SCLEROSIS INVOLVING INTRAPELVIC LYMPH NODES
201.57 HODGKIN'S DISEASE NODULAR SCLEROSIS INVOLVING SPLEEN
201.58 HODGKIN'S DISEASE NODULAR SCLEROSIS INVOLVING LYMPH NODES OF MULTIPLE SITES
201.60 HODGKIN'S DISEASE MIXED CELLULARITY UNSPECIFIED SITE
201.61 HODGKIN'S DISEASE MIXED CELLULARITY INVOLVING LYMPH NODES OF HEAD FACE AND NECK
201.62 HODGKIN'S DISEASE MIXED CELLULARITY INVOLVING INTRATHORACIC LYMPH NODES
201.63 HODGKIN'S DISEASE MIXED CELLULARITY INVOLVING INTRA-ABDOMINAL LYMPH NODES
201.64 HODGKIN'S DISEASE MIXED CELLULARITY INVOLVING LYMPH NODES OF AXILLA AND UPPER LIMB
201.65 HODGKIN'S DISEASE MIXED CELLULARITY INVOLVING LYMPH NODES OF INGUINAL REGION AND LOWER LIMB
201.66 HODGKIN'S DISEASE MIXED CELLULARITY INVOLVING INTRAPELVIC LYMPH NODES
201.67 HODGKIN'S DISEASE MIXED CELLULARITY INVOLVING SPLEEN
201.68 HODGKIN'S DISEASE MIXED CELLULARITY INVOLVING LYMPH NODES OF MULTIPLE SITES
201.70 HODGKIN'S DISEASE LYMPHOCYTIC DEPLETION UNSPECIFIED SITE
201.71 HODGKIN'S DISEASE LYMPHOCYTIC DEPLETION INVOLVING LYMPH NODES OF HEAD FACE AND NECK
201.72 HODGKIN'S DISEASE LYMPHOCYTIC DEPLETION INVOLVING INTRATHORACIC LYMPH NODES
201.73 HODGKIN'S DISEASE LYMPHOCYTIC DEPLETION INVOLVING INTRA-ABDOMINAL LYMPH NODES
201.74 HODGKIN'S DISEASE LYMPHOCYTIC DEPLETION INVOLVING LYMPH NODES OF AXILLA AND UPPER LIMB
201.75 HODGKIN'S DISEASE LYMPHOCYTIC DEPLETION INVOLVING LYMPH NODES OF INGUINAL REGION AND LOWER LIMB
201.76 HODGKIN'S DISEASE LYMPHOCYTIC DEPLETION INVOLVING INTRAPELVIC LYMPH NODES
201.77 HODGKIN'S DISEASE LYMPHOCYTIC DEPLETION INVOLVING SPLEEN
201.78 HODGKIN'S DISEASE LYMPHOCYTIC DEPLETION INVOLVING LYMPH NODES OF MULTIPLE SITES
201.90 HODGKIN'S DISEASE UNSPECIFIED TYPE UNSPECIFIED SITE
201.91 HODGKIN'S DISEASE UNSPECIFIED TYPE INVOLVING LYMPH NODES OF HEAD FACE AND NECK
201.92 HODGKIN'S DISEASE UNSPECIFIED TYPE INVOLVING INTRATHORACIC LYMPH NODES
201.93 HODGKIN'S DISEASE UNSPECIFIED TYPE INVOLVING INTRA-ABDOMINAL LYMPH NODES
201.94 HODGKIN'S DISEASE UNSPECIFIED TYPE INVOLVING LYMPH NODES OF AXILLA AND UPPER LIMB
201.95 HODGKIN'S DISEASE UNSPECIFIED TYPE INVOLVING LYMPH NODES OF INGUINAL REGION AND LOWER LIMB
201.96 HODGKIN'S DISEASE UNSPECIFIED TYPE INVOLVING INTRAPELVIC LYMPH NODES
201.97 HODGKIN'S DISEASE UNSPECIFIED TYPE INVOLVING SPLEEN
201.98 HODGKIN'S DISEASE UNSPECIFIED TYPE INVOLVING LYMPH NODES OF MULTIPLE SITES
202.00 NODULAR LYMPHOMA UNSPECIFIED SITE
202.01 NODULAR LYMPHOMA INVOLVING LYMPH NODES OF HEAD FACE AND NECK
202.02 NODULAR LYMPHOMA INVOLVING INTRATHORACIC LYMPH NODES
202.03 NODULAR LYMPHOMA INVOLVING INTRA-ABDOMINAL LYMPH NODES
202.04 NODULAR LYMPHOMA INVOLVING LYMPH NODES OF AXILLA AND UPPER LIMB
202.05 NODULAR LYMPHOMA INVOLVING LYMPH NODES OF INGUINAL REGION AND LOWER LIMB
202.06 NODULAR LYMPHOMA INVOLVING INTRAPELVIC LYMPH NODES
202.07 NODULAR LYMPHOMA INVOLVING SPLEEN
202.08 NODULAR LYMPHOMA INVOLVING LYMPH NODES OF MULTIPLE SITES
202.10 MYCOSIS FUNGOIDES UNSPECIFIED SITE
202.11 MYCOSIS FUNGOIDES INVOLVING LYMPH NODES OF HEAD FACE AND NECK
202.12 MYCOSIS FUNGOIDES INVOLVING INTRATHORACIC LYMPH NODES
202.13 MYCOSIS FUNGOIDES INVOLVING INTRA-ABDOMINAL LYMPH NODES
202.14 MYCOSIS FUNGOIDES INVOLVING LYMPH NODES OF AXILLA AND UPPER LIMB
202.15 MYCOSIS FUNGOIDES INVOLVING LYMPH NODES OF INGUINAL REGION AND LOWER LIMB
202.16 MYCOSIS FUNGOIDES INVOLVING INTRAPELVIC LYMPH NODES
202.17 MYCOSIS FUNGOIDES INVOLVING SPLEEN
202.18 MYCOSIS FUNGOIDES INVOLVING LYMPH NODES OF MULTIPLE SITES
202.20 SEZARY'S DISEASE UNSPECIFIED SITE
202.21 SEZARY'S DISEASE INVOLVING LYMPH NODES OF HEAD FACE AND NECK
202.22 SEZARY'S DISEASE INVOLVING INTRATHORACIC LYMPH NODES
202.23 SEZARY'S DISEASE INVOLVING INTRA-ABDOMINAL LYMPH NODES
202.24 SEZARY'S DISEASE INVOLVING LYMPH NODES OF AXILLA AND UPPER LIMB
202.25 SEZARY'S DISEASE INVOLVING LYMPH NODES OF INGUINAL REGION AND LOWER LIMB
202.26 SEZARY'S DISEASE INVOLVING INTRAPELVIC LYMPH NODES
202.27 SEZARY'S DISEASE INVOLVING SPLEEN
202.28 SEZARY'S DISEASE INVOLVING LYMPH NODES OF MULTIPLE SITES
202.30 MALIGNANT HISTIOCYTOSIS UNSPECIFIED SITE
202.31 MALIGNANT HISTIOCYTOSIS INVOLVING LYMPH NODES OF HEAD FACE AND NECK
202.32 MALIGNANT HISTIOCYTOSIS INVOLVING INTRATHORACIC LYMPH NODES
202.33 MALIGNANT HISTIOCYTOSIS INVOLVING INTRA-ABDOMINAL LYMPH NODES
202.34 MALIGNANT HISTIOCYTOSIS INVOLVING LYMPH NODES OF AXILLA AND UPPER LIMB
202.35 MALIGNANT HISTIOCYTOSIS INVOLVING LYMPH NODES OF INGUINAL REGION AND LOWER LIMB
202.36 MALIGNANT HISTIOCYTOSIS INVOLVING INTRAPELVIC LYMPH NODES
202.37 MALIGNANT HISTIOCYTOSIS INVOLVING SPLEEN
202.38 MALIGNANT HISTIOCYTOSIS INVOLVING LYMPH NODES OF MULTIPLE SITES
202.40 LEUKEMIC RETICULOENDOTHELIOSIS UNSPECIFIED SITE
202.41 LEUKEMIC RETICULOENDOTHELIOSIS INVOLVING LYMPH NODES OF HEAD FACE AND NECK
202.42 LEUKEMIC RETICULOENDOTHELIOSIS INVOLVING INTRATHORACIC LYMPH NODES
202.43 LEUKEMIC RETICULOENDOTHELIOSIS INVOLVING INTRA-ABDOMINAL LYMPH NODES
202.44 LEUKEMIC RETICULOENDOTHELIOSIS INVOLVING LYMPH NODES OF AXILLA AND UPPER ARM
202.45 LEUKEMIC RETICULOENDOTHELIOSIS INVOLVING LYMPH NODES OF INGUINAL REGION AND LOWER LIMB
202.46 LEUKEMIC RETICULOENDOTHELIOSIS INVOLVING INTRAPELVIC LYMPH NODES
202.47 LEUKEMIC RETICULOENDOTHELIOSIS INVOLVING SPLEEN
202.48 LEUKEMIC RETICULOENDOTHELIOSIS INVOLVING LYMPH NODES OF MULTIPLE SITES
202.50 LETTERER-SIWE DISEASE UNSPECIFIED SITE
202.51 LETTERER-SIWE DISEASE INVOLVING LYMPH NODES OF HEAD FACE AND NECK
202.52 LETTERER-SIWE DISEASE INVOLVING INTRATHORACIC LYMPH NODES
202.53 LETTERER-SIWE DISEASE INVOLVING INTRA-ABDOMINAL LYMPH NODES
202.54 LETTERER-SIWE DISEASE INVOLVING LYMPH NODES OF AXILLA AND UPPER LIMB
202.55 LETTERER-SIWE DISEASE INVOLVING LYMPH NODES OF INGUINAL REGION AND LOWER LIMB
202.56 LETTERER-SIWE DISEASE INVOLVING INTRAPELVIC LYMPH NODES
202.57 LETTERER-SIWE DISEASE INVOLVING SPLEEN
202.58 LETTERER-SIWE DISEASE INVOLVING LYMPH NODES OF MULTIPLE SITES
202.60 MALIGNANT MAST CELL TUMORS UNSPECIFIED SITE
202.61 MALIGNANT MAST CELL TUMORS INVOLVING LYMPH NODES OF HEAD FACE AND NECK
202.62 MALIGNANT MAST CELL TUMORS INVOLVING INTRATHORACIC LYMPH NODES
202.63 MALIGNANT MAST CELL TUMORS INVOLVING INTRA-ABDOMINAL LYMPH NODES
202.64 MALIGNANT MAST CELL TUMORS INVOLVING LYMPH NODES OF AXILLA AND UPPER LIMB
202.65 MALIGNANT MAST CELL TUMORS INVOLVING LYMPH NODES OF INGUINAL REGION AND LOWER LIMB
202.66 MALIGNANT MAST CELL TUMORS INVOLVING INTRAPELVIC LYMPH NODES
202.67 MALIGNANT MAST CELL TUMORS INVOLVING SPLEEN
202.68 MALIGNANT MAST CELL TUMORS INVOLVING LYMPH NODES OF MULTIPLE SITES
202.70 PERIPHERAL T CELL LYMPHOMA, UNSPECIFIED SITE, EXTRANODAL AND SOLID ORGAN SITES
202.71 PERIPHERAL T CELL LYMPHOMA, LYMPH NODES OF HEAD, FACE, AND NECK
202.72 PERIPHERAL T CELL LYMPHOMA, INTRATHORACIC LYMPH NODES
202.73 PERIPHERAL T CELL LYMPHOMA, INTRA-ABDOMINAL LYMPH NODES
202.74 PERIPHERAL T CELL LYMPHOMA, LYMPH NODES OF AXILLA AND UPPER LIMB
202.75 PERIPHERAL T CELL LYMPHOMA, LYMPH NODES OF INGUINAL REGION AND LOWER LIMB
202.76 PERIPHERAL T CELL LYMPHOMA, INTRAPELVIC LYMPH NODES
202.77 PERIPHERAL T CELL LYMPHOMA, SPLEEN
202.78 PERIPHERAL T CELL LYMPHOMA, LYMPH NODES OF MULTIPLE SITES
202.80 OTHER MALIGNANT LYMPHOMAS UNSPECIFIED SITE
202.81 OTHER MALIGNANT LYMPHOMAS INVOLVING LYMPH NODES OF HEAD FACE AND NECK
202.82 OTHER MALIGNANT LYMPHOMAS INVOLVING INTRATHORACIC LYMPH NODES
202.83 OTHER MALIGNANT LYMPHOMAS INVOLVING INTRA-ABDOMINAL LYMPH NODES
202.84 OTHER MALIGNANT LYMPHOMAS INVOLVING LYMPH NODES OF AXILLA AND UPPER LIMB
202.85 OTHER MALIGNANT LYMPHOMAS INVOLVING LYMPH NODES OF INGUINAL REGION AND LOWER LIMB
202.86 OTHER MALIGNANT LYMPHOMAS INVOLVING INTRAPELVIC LYMPH NODES
202.87 OTHER MALIGNANT LYMPHOMAS INVOLVING SPLEEN
202.88 OTHER MALIGNANT LYMPHOMAS INVOLVING LYMPH NODES OF MULTIPLE SITES
202.90 OTHER AND UNSPECIFIED MALIGNANT NEOPLASMS OF LYMPHOID AND HISTIOCYTIC TISSUE UNSPECIFIED SITE
202.91 OTHER AND UNSPECIFIED MALIGNANT NEOPLASMS OF LYMPHOID AND HISTIOCYTIC TISSUE INVOLVING LYMPH NODES OF HEAD FACE AND NECK
202.92 OTHER AND UNSPECIFIED MALIGNANT NEOPLASMS OF LYMPHOID AND HISTIOCYTIC TISSUE INVOLVING INTRATHORACIC LYMPH NODES
202.93 OTHER AND UNSPECIFIED MALIGNANT NEOPLASMS OF LYMPHOID AND HISTIOCYTIC TISSUE INVOLVING INTRA-ABDOMINAL LYMPH NODES
202.94 OTHER AND UNSPECIFIED MALIGNANT NEOPLASMS OF LYMPHOID AND HISTIOCYTIC TISSUE INVOLVING LYMPH NODES OF AXILLA AND UPPER LIMB
202.95 OTHER AND UNSPECIFIED MALIGNANT NEOPLASMS OF LYMPHOID AND HISTIOCYTIC TISSUE INVOLVING LYMPH NODES OF INGUINAL REGION AND LOWER LIMB
202.96 OTHER AND UNSPECIFIED MALIGNANT NEOPLASMS OF LYMPHOID AND HISTIOCYTIC TISSUE INVOLVING INTRAPELVIC LYMPH NODES
202.97 OTHER AND UNSPECIFIED MALIGNANT NEOPLASMS OF LYMPHOID AND HISTIOCYTIC TISSUE INVOLVING SPLEEN
202.98 OTHER AND UNSPECIFIED MALIGNANT NEOPLASMS OF LYMPHOID AND HISTIOCYTIC TISSUE INVOLVING LYMPH NODES OF MULTIPLE SITES
203.00 MULTIPLE MYELOMA, WITHOUT MENTION OF HAVING ACHIEVED REMISSION
203.01 MULTIPLE MYELOMA IN REMISSION
203.02 MULTIPLE MYELOMA, IN RELAPSE
203.10 PLASMA CELL LEUKEMIA, WITHOUT MENTION OF HAVING ACHIEVED REMISSION
203.11 PLASMA CELL LEUKEMIA IN REMISSION
203.12 PLASMA CELL LEUKEMIA, IN RELAPSE
203.80 OTHER IMMUNOPROLIFERATIVE NEOPLASMS, WITHOUT MENTION OF HAVING ACHIEVED REMISSION
203.81 OTHER IMMUNOPROLIFERATIVE NEOPLASMS IN REMISSION
203.82 OTHER IMMUNOPROLIFERATIVE NEOPLASMS, IN RELAPSE
204.00 ACUTE LYMPHOID LEUKEMIA, WITHOUT MENTION OF HAVING ACHIEVED REMISSION
204.01 LYMPHOID LEUKEMIA ACUTE IN REMISSION
204.02 ACUTE LYMPHOID LEUKEMIA, IN RELAPSE
204.10 CHRONIC LYMPHOID LEUKEMIA, WITHOUT MENTION OF HAVING ACHIEVED REMISSION
204.11 LYMPHOID LEUKEMIA CHRONIC IN REMISSION
204.12 CHRONIC LYMPHOID LEUKEMIA, IN RELAPSE
204.20 SUBACUTE LYMPHOID LEUKEMIA, WITHOUT MENTION OF HAVING ACHIEVED REMISSION
204.21 LYMPHOID LEUKEMIA SUBACUTE IN REMISSION
204.22 SUBACUTE LYMPHOID LEUKEMIA, IN RELAPSE
204.80 OTHER LYMPHOID LEUKEMIA, WITHOUT MENTION OF HAVING ACHIEVED REMISSION
204.81 OTHER LYMPHOID LEUKEMIA IN REMISSION
204.82 OTHER LYMPHOID LEUKEMIA, IN RELAPSE
204.90 UNSPECIFIED LYMPHOID LEUKEMIA, WITHOUT MENTION OF HAVING ACHIEVED REMISSION
204.91 UNSPECIFIED LYMPHOID LEUKEMIA IN REMISSION
204.92 UNSPECIFIED LYMPHOID LEUKEMIA, IN RELAPSE
205.00 ACUTE MYELOID LEUKEMIA, WITHOUT MENTION OF HAVING ACHIEVED REMISSION
205.01 MYELOID LEUKEMIA ACUTE IN REMISSION
205.02 ACUTE MYELOID LEUKEMIA, IN RELAPSE
205.10 CHRONIC MYELOID LEUKEMIA, WITHOUT MENTION OF HAVING ACHIEVED REMISSION
205.11 MYELOID LEUKEMIA CHRONIC IN REMISSION
205.12 CHRONIC MYELOID LEUKEMIA, IN RELAPSE
205.20 SUBACUTE MYELOID LEUKEMIA, WITHOUT MENTION OF HAVING ACHIEVED REMISSION
205.21 MYELOID LEUKEMIA SUBACUTE IN REMISSION
205.22 SUBACUTE MYELOID LEUKEMIA, IN RELAPSE
205.30 MYELOID SARCOMA, WITHOUT MENTION OF HAVING ACHIEVED REMISSION
205.31 MYELOID SARCOMA IN REMISSION
205.32 MYELOID SARCOMA, IN RELAPSE
205.80 OTHER MYELOID LEUKEMIA, WITHOUT MENTION OF HAVING ACHIEVED REMISSION
205.81 OTHER MYELOID LEUKEMIA IN REMISSION
205.82 OTHER MYELOID LEUKEMIA, IN RELAPSE
205.90 UNSPECIFIED MYELOID LEUKEMIA, WITHOUT MENTION OF HAVING ACHIEVED REMISSION
205.91 UNSPECIFIED MYELOID LEUKEMIA IN REMISSION
205.92 UNSPECIFIED MYELOID LEUKEMIA, IN RELAPSE
206.00 ACUTE MONOCYTIC LEUKEMIA, WITHOUT MENTION OF HAVING ACHIEVED REMISSION
206.01 MONOCYTIC LEUKEMIA ACUTE IN REMISSION
206.02 ACUTE MONOCYTIC LEUKEMIA, IN RELAPSE
206.10 CHRONIC MONOCYTIC LEUKEMIA, WITHOUT MENTION OF HAVING ACHIEVED REMISSION
206.11 MONOCYTIC LEUKEMIA CHRONIC IN REMISSION
206.12 CHRONIC MONOCYTIC LEUKEMIA, IN RELAPSE
206.20 SUBACUTE MONOCYTIC LEUKEMIA, WITHOUT MENTION OF HAVING ACHIEVED REMISSION
206.21 MONOCYTIC LEUKEMIA SUBACUTE IN REMISSION
206.22 SUBACUTE MONOCYTIC LEUKEMIA, IN RELAPSE
206.80 OTHER MONOCYTIC LEUKEMIA, WITHOUT MENTION OF HAVING ACHIEVED REMISSION
206.81 OTHER MONOCYTIC LEUKEMIA IN REMISSION
206.82 OTHER MONOCYTIC LEUKEMIA, IN RELAPSE
206.90 UNSPECIFIED MONOCYTIC LEUKEMIA, WITHOUT MENTION OF HAVING ACHIEVED REMISSION
206.91 UNSPECIFIED MONOCYTIC LEUKEMIA IN REMISSION
206.92 UNSPECIFIED MONOCYTIC LEUKEMIA, IN RELAPSE
207.00 ACUTE ERYTHREMIA AND ERYTHROLEUKEMIA, WITHOUT MENTION OF HAVING ACHIEVED REMISSION
207.01 ACUTE ERYTHREMIA AND ERYTHROLEUKEMIA IN REMISSION
207.02 ACUTE ERYTHREMIA AND ERYTHROLEUKEMIA, IN RELAPSE
207.10 CHRONIC ERYTHREMIA, WITHOUT MENTION OF HAVING ACHIEVED REMISSION
207.11 CHRONIC ERYTHREMIA IN REMISSION
207.12 CHRONIC ERYTHREMIA, IN RELAPSE
207.20 MEGAKARYOCYTIC LEUKEMIA, WITHOUT MENTION OF HAVING ACHIEVED REMISSION
207.21 MEGAKARYOCYTIC LEUKEMIA IN REMISSION
207.22 MEGAKARYOCYTIC LEUKEMIA, IN RELAPSE
207.80 OTHER SPECIFIED LEUKEMIA, WITHOUT MENTION OF HAVING ACHIEVED REMISSION
207.81 OTHER SPECIFIED LEUKEMIA IN REMISSION
207.82 OTHER SPECIFIED LEUKEMIA, IN RELAPSE
208.00 ACUTE LEUKEMIA OF UNSPECIFIED CELL TYPE, WITHOUT MENTION OF HAVING ACHIEVED REMISSION
208.01 LEUKEMIA OF UNSPECIFIED CELL TYPE ACUTE IN REMISSION
208.02 ACUTE LEUKEMIA OF UNSPECIFIED CELL TYPE, IN RELAPSE
208.10 CHRONIC LEUKEMIA OF UNSPECIFIED CELL TYPE, WITHOUT MENTION OF HAVING ACHIEVED REMISSION
208.11 LEUKEMIA OF UNSPECIFIED CELL TYPE CHRONIC IN REMISSION
208.12 CHRONIC LEUKEMIA OF UNSPECIFIED CELL TYPE, IN RELAPSE
208.20 SUBACUTE LEUKEMIA OF UNSPECIFIED CELL TYPE, WITHOUT MENTION OF HAVING ACHIEVED REMISSION
208.21 LEUKEMIA OF UNSPECIFIED CELL TYPE SUBACUTE IN REMISSION
208.22 SUBACUTE LEUKEMIA OF UNSPECIFIED CELL TYPE, IN RELAPSE
208.80 OTHER LEUKEMIA OF UNSPECIFIED CELL TYPE, WITHOUT MENTION OF HAVING ACHIEVED REMISSION
208.81 OTHER LEUKEMIA OF UNSPECIFIED CELL TYPE IN REMISSION
208.82 OTHER LEUKEMIA OF UNSPECIFIED CELL TYPE, IN RELAPSE
208.90 UNSPECIFIED LEUKEMIA, WITHOUT MENTION OF HAVING ACHIEVED REMISSION
208.91 UNSPECIFIED LEUKEMIA IN REMISSION
208.92 UNSPECIFIED LEUKEMIA, IN RELAPSE
227.0 BENIGN NEOPLASM OF ADRENAL GLAND
233.0 CARCINOMA IN SITU OF BREAST
238.71 ESSENTIAL THROMBOCYTHEMIA
238.72 LOW GRADE MYELODYSPLASTIC SYNDROME LESIONS
238.73 HIGH GRADE MYELODYSPLASTIC SYNDROME LESIONS
238.74 MYELODYSPLASTIC SYNDROME WITH 5Q DELETION
238.75 MYELODYSPLASTIC SYNDROME, UNSPECIFIED
238.76 MYELOFIBROSIS WITH MYELOID METAPLASIA
238.77 POST-TRANSPLANT LYMPHOPROLIFERATIVE DISORDER (PTLD)
238.79 OTHER LYMPHATIC AND HEMATOPOIETIC TISSUES
259.2 CARCINOID SYNDROME
273.1 MONOCLONAL PARAPROTEINEMIA
273.2 OTHER PARAPROTEINEMIAS
273.3 MACROGLOBULINEMIA
273.8 OTHER DISORDERS OF PLASMA PROTEIN METABOLISM
273.9 UNSPECIFIED DISORDER OF PLASMA PROTEIN METABOLISM
279.00 HYPOGAMMAGLOBULINEMIA UNSPECIFIED
279.01 SELECTIVE IGA IMMUNODEFICIENCY
279.02 SELECTIVE IGM IMMUNODEFICIENCY
279.03 OTHER SELECTIVE IMMUNOGLOBULIN DEFICIENCIES
279.04 CONGENITAL HYPOGAMMAGLOBULINEMIA
279.05 IMMUNODEFICIENCY WITH INCREASED IGM
279.06 COMMON VARIABLE IMMUNODEFICIENCY
279.09 OTHER DEFICIENCY OF HUMORAL IMMUNITY
279.10 IMMUNODEFICIENCY WITH PREDOMINANT T-CELL DEFECT UNSPECIFIED
279.11 DIGEORGE'S SYNDROME
279.12 WISKOTT-ALDRICH SYNDROME
279.13 NEZELOF'S SYNDROME
279.19 OTHER DEFICIENCY OF CELL-MEDIATED IMMUNITY
279.2 COMBINED IMMUNITY DEFICIENCY
279.3 UNSPECIFIED IMMUNITY DEFICIENCY
279.41 AUTOIMMUNE LYMPHOPROLIFERATIVE SYNDROME
279.49 AUTOIMMUNE DISEASE, NOT ELSEWHERE CLASSIFIED
279.50 GRAFT-VERSUS-HOST DISEASE, UNSPECIFIED
279.51 ACUTE GRAFT-VERSUS-HOST DISEASE
279.52 CHRONIC GRAFT-VERSUS-HOST DISEASE
279.53 ACUTE ON CHRONIC GRAFT-VERSUS-HOST DISEASE
279.8 OTHER SPECIFIED DISORDERS INVOLVING THE IMMUNE MECHANISM
279.9 UNSPECIFIED DISORDER OF IMMUNE MECHANISM
282.0 HEREDITARY SPHEROCYTOSIS
282.1 HEREDITARY ELLIPTOCYTOSIS
282.5 SICKLE-CELL TRAIT
282.60 SICKLE-CELL DISEASE UNSPECIFIED
282.61 HB-SS DISEASE WITHOUT CRISIS
282.62 HB-SS DISEASE WITH CRISIS
282.63 SICKLE-CELL/HB-C DISEASE WITHOUT CRISIS
282.64 SICKLE-CELL/HB C DISEASE WITH CRISIS
282.68 OTHER SICKLE-CELL DISEASE WITHOUT CRISIS
282.69 OTHER SICKLE-CELL DISEASE WITH CRISIS
282.7 OTHER HEMOGLOBINOPATHIES
283.2 HEMOGLOBINURIA DUE TO HEMOLYSIS FROM EXTERNAL CAUSES
284.01 CONSTITUTIONAL RED BLOOD CELL APLASIA
284.09 OTHER CONSTITUTIONAL APLASTIC ANEMIA
284.1 PANCYTOPENIA
284.2 MYELOPHTHISIS
284.81 RED CELL APLASIA (ACQUIRED) (ADULT) (WITH THYMOMA)
284.89 OTHER SPECIFIED APLASTIC ANEMIAS
284.9 APLASTIC ANEMIA UNSPECIFIED
285.0 SIDEROBLASTIC ANEMIA
285.22 ANEMIA IN NEOPLASTIC DISEASE
285.8 OTHER SPECIFIED ANEMIAS
285.9 ANEMIA UNSPECIFIED
287.1 QUALITATIVE PLATELET DEFECTS
287.30 PRIMARY THROMBOCYTOPENIA,UNSPECIFIED
287.31 IMMUNE THROMBOCYTOPENIC PURPURA
287.32 EVANS’ SYNDROME
287.33 CONGENITAL AND HEREDITARY THROMBOCYTOPENIC PURPURA
287.39 OTHER PRIMARY THROMBOCYTOPENIA
287.5 THROMBOCYTOPENIA UNSPECIFIED
288.00 NEUTROPENIA, UNSPECIFIED
288.01 CONGENITAL NEUTROPENIA
288.02 CYCLIC NEUTROPENIA
288.03 DRUG INDUCED NEUTROPENIA
288.04 NEUTROPENIA DUE TO INFECTION
288.09 OTHER NEUTROPENIA
288.1 FUNCTIONAL DISORDERS OF POLYMORPHONUCLEAR NEUTROPHILS
288.2 GENETIC ANOMALIES OF LEUKOCYTES
288.3 EOSINOPHILIA
288.4 HEMOPHAGOCYTIC SYNDROMES
288.50 LEUKOCYTOPENIA, UNSPECIFIED
288.51 LYMPHOCYTOPENIA
288.59 OTHER DECREASED WHITE BLOOD CELL COUNT
288.60 LEUKOCYTOSIS, UNSPECIFIED
288.61 LYMPHOCYTOSIS (SYMPTOMATIC)
288.62 LEUKEMOID REACTION
288.63 MONOCYTOSIS (SYMPTOMATIC)
288.64 PLASMACYTOSIS
288.65 BASOPHILIA
288.69 OTHER ELEVATED WHITE BLOOD CELL COUNT
288.8 OTHER SPECIFIED DISEASE OF WHITE BLOOD CELLS
288.9 UNSPECIFIED DISEASE OF WHITE BLOOD CELLS
289.4 HYPERSPLENISM
289.50 DISEASE OF SPLEEN UNSPECIFIED
289.51 CHRONIC CONGESTIVE SPLENOMEGALY
289.52 SPLENIC SEQUESTRATION
289.53 NEUTROPENIC SPLENOMEGALY
289.59 OTHER DISEASES OF SPLEEN
289.83* MYELOFIBROSIS
289.9 UNSPECIFIED DISEASES OF BLOOD AND BLOOD-FORMING ORGANS
364.3 UNSPECIFIED IRIDOCYCLITIS
452 PORTAL VEIN THROMBOSIS
453.9 EMBOLISM AND THROMBOSIS OF UNSPECIFIED SITE
555.0 REGIONAL ENTERITIS OF SMALL INTESTINE
555.1 REGIONAL ENTERITIS OF LARGE INTESTINE
555.2 REGIONAL ENTERITIS OF SMALL INTESTINE WITH LARGE INTESTINE
555.9 REGIONAL ENTERITIS OF UNSPECIFIED SITE
556.0 ULCERATIVE (CHRONIC) ENTEROCOLITIS
556.1 ULCERATIVE (CHRONIC) ILEOCOLITIS
556.2 ULCERATIVE (CHRONIC) PROCTITIS
556.3 ULCERATIVE (CHRONIC) PROCTOSIGMOIDITIS
556.4 PSEUDOPOLYPOSIS OF COLON
556.5 LEFT-SIDED ULCERATIVE (CHRONIC) COLITIS
556.6 UNIVERSAL ULCERATIVE (CHRONIC) COLITIS
556.9 ULCERATIVE COLITIS UNSPECIFIED
630 HYDATIDIFORM MOLE
696.0 PSORIATIC ARTHROPATHY
714.30 CHRONIC OR UNSPECIFIED POLYARTICULAR JUVENILE RHEUMATOID ARTHRITIS
720.0 ANKYLOSING SPONDYLITIS
720.1 SPINAL ENTHESOPATHY
720.2 SACROILIITIS NOT ELSEWHERE CLASSIFIED
720.81 INFLAMMATORY SPONDYLOPATHIES IN DISEASES CLASSIFIED ELSEWHERE
720.89 OTHER INFLAMMATORY SPONDYLOPATHIES
720.9 UNSPECIFIED INFLAMMATORY SPONDYLOPATHY
785.6 ENLARGEMENT OF LYMPH NODES
789.2 SPLENOMEGALY
789.30 ABDOMINAL OR PELVIC SWELLING MASS OR LUMP UNSPECIFIED SITE
789.31 ABDOMINAL OR PELVIC SWELLING MASS OR LUMP RIGHT UPPER QUARDANT
789.32 ABDOMINAL OR PELVIC SWELLING MASS OR LUMP LEFT UPPER QUADRANT
789.33 ABDOMINAL OR PELVIC SWELLING MASS OR LUMP RIGHT LOWER QUADRANT
789.34 ABDOMINAL OR PELVIC SWELLING MASS OR LUMP LEFT LOWER QUADRANT
789.35 ABDOMINAL OR PELVIC SWELLING MASS OR LUMP PERIUMBILIC
789.36 ABDOMINAL OR PELVIC SWELLING MASS OR LUMP EPIGASTRIC
789.37 ABDOMINAL OR PELVIC SWELLING MASS OR LUMP GENERALIZED
789.39 ABDOMINAL OR PELVIC SWELLING MASS OR LUMP OTHER SPECIFIED SITE
791.0 PROTEINURIA
795.4 OTHER NONSPECIFIC ABNORMAL HISTOLOGICAL FINDINGS
996.80 COMPLICATIONS OF UNSPECIFIED TRANSPLANTED ORGAN
996.81 COMPLICATIONS OF TRANSPLANTED KIDNEY
996.82 COMPLICATIONS OF TRANSPLANTED LIVER
996.83 COMPLICATIONS OF TRANSPLANTED HEART
996.84 COMPLICATIONS OF TRANSPLANTED LUNG
996.85 COMPLICATIONS OF TRANSPLANTED BONE MARROW
996.86 COMPLICATIONS OF TRANSPLANTED PANCREAS
996.87 COMPLICATIONS OF TRANSPLANTED ORGAN INTESTINE
996.89 COMPLICATIONS OF OTHER SPECIFIED TRANSPLANTED ORGAN
V08 ASYMPTOMATIC HUMAN IMMUNODEFICIENCY VIRUS (HIV) INFECTION STATUS
V10.60 PERSONAL HISTORY OF UNSPECIFIED LEUKEMIA
V10.61 PERSONAL HISTORY OF LYMPHOID LEUKEMIA
V10.62 PERSONAL HISTORY OF MYELOID LEUKEMIA
V10.63 PERSONAL HISTORY OF MONOCYTIC LEUKEMIA
V10.69 PERSONAL HISTORY OF OTHER LEUKEMIA
V42.0* KIDNEY REPLACED BY TRANSPLANT
V42.1* HEART REPLACED BY TRANSPLANT
V42.2* HEART VALVE REPLACED BY TRANSPLANT
V42.3* SKIN REPLACED BY TRANSPLANT
V42.4* BONE REPLACED BY TRANSPLANT
V42.5* CORNEA REPLACED BY TRANSPLANT
V42.6* LUNG REPLACED BY TRANSPLANT
V42.7* LIVER REPLACED BY TRANSPLANT
V42.81* BONE MARROW REPLACED BY TRANSPLANT
V42.82* PERIPHERAL STEM CELLS REPLACED BY TRANSPLANT
V42.83* PANCREAS REPLACED BY TRANSPLANT
V42.84* ORGAN OR TISSUE REPLACED BY TRANSPLANT INTESTINES
V42.89* OTHER SPECIFIED ORGAN OR TISSUE REPLACED BY TRANSPLANT
V42.9 UNSPECIFIED ORGAN OR TISSUE REPLACED BY TRANSPLANT
*According to the ICD-9-CM book, diagnosis codes V42.0-V42.9 and 289.83 are secondary codes and should not be billed as a primary diagnosis.
Documentation Requirements
• The medical record must include documentation of clinical and morphologic findings, cell counts (quantitative values), and radiology and cytogenetic findings when available.
• The referring/ordering physician or pathologist must provide the most specific suspected diagnosis or differential diagnosis that will allow the performing laboratory to determine an appropriate panel of cell markers.
o This must be documented in the orders provided to the performing laboratory.
• To justify markers in excess of twenty-four (24), the final FCM report must contain the following supporting documentation:
o Clinical information summary
o Specific marker results
o Diagnosis and interpretation
o Rationale to support each marker in excess of twenty-four (24)
o Documentation should support that the results of FCM will be utilized in the management of the patient’s condition.
Utilization Guidelines
• Routine use of flow cytometry absent of clinical indication for its use will be considered screening and will not be allowed.
• For flow cytometry, cell cycle or DNA analysis, it is not expected that more than one unit total (given day or an episode of care) would be done for a patient with a covered indication.
o Therefore, utilization would be one time for a beneficiary with a given diagnosis (unless the patient had new disease) and generally should be performed before treatment is initiated.
• It is not expected that more than twenty-four (24) markers (cell surface, cytoplasmic, or nuclear) will be required.
o When more than twenty-four (24) markers are performed, documentation should support the medical necessity of the excess markers.
Treatment Logic
• Flow cytometry (FCM) is a procedure which simultaneously measures and analyzes multiple physical characteristics of single cells, as they flow in a fluid stream through a beam of light.
o The light activates fluorescent molecules, resulting in light scatter, which forms a pattern that can be analyzed for cell characteristics.
o FCM can be used to analyze blood, body fluids, CSF, bone marrow, lymph node, tonsil, spleen and other solid organs.
o Information from the analyzed cells may help determine prognosis, aid in the analysis of effusions, urine, or other fluids in which cancer cells may be few or mixed with benign cells, detect metastases in lymph nodes or bone marrow, or to supplement fine needle aspiration.
• The flow cytometer is made up of three main systems: fluidics, optics and electronics.
o The fluidic system transports particles in a stream to the laser beam.
o The optics system consists of lasers to illuminate the particles in the sample stream and optical filters to direct the resulting light signals to the appropriate detectors.
o The electronics system converts the detected light signals into electronic signals that can be processed by the computer.
o Some flow cytometers have a sorting feature which allows the electronic system to initiate sorting decisions to charge and deflect particles.
Sources of Information and Basis for Decision
Basiji, D.A, Ortyn, W.E. et al (2007) Cellular image analysis and imaging by flow cytometry. Clinics in laboratory medicine (27) pp. 653-670. Retrieved from http://www.labmed.theclinics.com/
Borowitz, M.J. (2008) Flow cytometry in oncologic diagnosis . In Abeloff’s Clinical Oncology, 4th ed. Chapter 17. Retrieved from MD Consult May 5, 2010.
B cells and T cells (2010, February 28). Retrieved May 5, 2010 from http://users.rcn.com/jkimball.ma.ultranet/BiologyPages/
FCSO LCD 321247, Flow Cytometry, 09/30/2010. The official local coverage determination (LCD) is the version on the Medicare coverage database at www.cms.gov/medicare-coverage-database/ .
LCD for flow cytometry (L17742) Palmetto GBA
LCD for flow cytometry (L30161) Wisconsin Physicians Service insurance corporation
Draft LCD for flow cytometry (DL30692) Palmetto GBA
Rahman, M: Introduction to flow cytometry. (May 24, 2006). Retrieved April 22, 2010 from ABD serotec website, ,http://www.bath.ac.uk/ceos/bioimaging/documents/
Tung, J.W., Heydari, K., Tirouvanziam, R., et al. (2007) Modern flow cytometry: a practical approach. Clinics in laboratory medicine. (27) pp453-468. Retrieved from http://www.labmed.theclinics.com/
09/30/2010
The official local coverage determination (LCD) is the version on the Medicare coverage database at www.cms.gov/medicare-coverage-database/ .
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