Medications Used for the Treatment of Leukemia and Their Associated ICD-10 Codes

Kristin A. Esposito, CPhT

July 2016, Vol 6, No 7 - ICD Codes


This detailed article of codes related to leukemia is intended to assist practice managers and other healthcare providers and payers to ensure their proper use of coding and billing information associated with the treatment of patients with leukemia.

The following sections include:

  • Associated ICD-10-CM codes used for the classification of leukemia
  • Drugs that have been approved by the FDA for the treatment of leukemia
  • Drugs for Compendia off-label uses have no FDA-approved uses in leukemia. However, drugs that are FDA approved for at least one of the leukemia ICD-10-CM codes may also have Compendia off-label uses
  • Drugs that are Compendia-listed for off-label use for leukemia based on clinical studies that suggest beneficial use in some cases. Please note: If a check mark appears in the FDA column, it will NOT appear in the Compendia off-label use column
  • Corresponding HCPCS/CPT® codes and code descriptions
  • Possible CPT® administration codes for the drugs

Associated ICD-10-CM Codes

C90.1 Plasma cell leukemia
  C90.10 Plasma cell leukemia, not having achieved remission
  C90.11 Plasma cell leukemia, in remission
  C90.12 Plasma cell leukemia, in relapse
C90.2 Extramedullary plasmacytoma
  C90.20 Extramedullary plasmacytoma, not having achieved remission
  C90.21 Extramedullary plasmacytoma, in remission
  C90.22 Extramedullary plasmacytoma, in relapse
C90.3 Solitary plasmacytoma
  C90.30 Solitary plasmacytoma, not having achieved remission
  C90.31 Solitary plasmacytoma, in remission
  C90.32 Solitary plasmacytoma, in relapse
C91 Lymphoid leukemia
C91.0 Acute lymphoblastic leukemia [ALL]
  C91.00 Acute lymphoblastic leukemia, not having achieved remission
  C91.01 Acute lymphoblastic leukemia, in remission
  C91.02 Acute lymphoblastic leukemia, in relapse
C91.1 Chronic lymphocytic leukemia of B-cell type
  C91.10 Chronic lymphocytic leukemia of B-cell type, not having achieved remission
  C91.11 Chronic lymphocytic leukemia of B-cell type, in remission
  C91.12 Chronic lymphocytic leukemia of B-cell type, in relapse
C91.3 Prolymphocytic leukemia of B-cell type
  C91.30 Prolymphocytic leukemia of B-cell type, not having achieved remission
  C91.31 Prolymphocytic leukemia of B-cell type, in remission
  C91.32 Prolymphocytic leukemia of B-cell type, in relapse
C91.4 Hairy cell leukemia
  C91.40 Hairy cell leukemia, not having achieved remission
  C91.41 Hairy cell leukemia, in remission
  C91.42 Hairy cell leukemia, in relapse
C91.5 Adult T-cell lymphoma/leukemia (HTLV-1–associated)
  C91.50 Adult T-cell lymphoma/leukemia (HTLV-1–associated), not having achieved remission
  C91.51 Adult T-cell lymphoma/leukemia (HTLV-1–associated), in remission
  C91.52 Adult T-cell lymphoma/leukemia (HTLV-1–associated), in relapse
C91.6 Prolymphocytic leukemia of T-cell type
  C91.60 Prolymphocytic leukemia of T-cell type, not having achieved remission
  C91.61 Prolymphocytic leukemia of T-cell type, in remission
  C91.62 Prolymphocytic leukemia of T-cell type, in relapse
C91.9 Lymphoid leukemia, unspecified
  C91.90 Lymphoid leukemia, unspecified, not having achieved remission
  C91.91 Lymphoid leukemia, unspecified, in remission
  C91.92 Lymphoid leukemia, unspecified, in relapse
C91.A Mature B-cell leukemia Burkitt-type
  C91.A0 Mature B-cell leukemia Burkitt-type, not having achieved remission
  C91.A1 Mature B-cell leukemia Burkitt-type, in remission
  C91.A2 Mature B-cell leukemia Burkitt-type, in relapse
C91.Z Other lymphoid leukemia
  C91.Z0 Other lymphoid leukemia, not having achieved remission
  C91.Z1 Other lymphoid leukemia, in remission
  C91.Z2 Other lymphoid leukemia, in relapse
C92 Myeloid leukemia
C92.0 Acute myeloblastic leukemia
  C92.00 Acute myeloblastic leukemia, not having achieved remission
  C92.01 Acute myeloblastic leukemia, in remission
  C92.02 Acute myeloblastic leukemia, in relapse
C92.1 Chronic myeloid leukemia, BCR/ABL-positive
  C92.10 Chronic myeloid leukemia, BCR/ABL-positive, not having achieved remission
  C92.11 Chronic myeloid leukemia, BCR/ABL-positive, in remission
  C92.12 Chronic myeloid leukemia, BCR/ABL-positive, in relapse
C92.2 Atypical chronic myeloid leukemia, BCR/ABL-negative
  C92.20 Atypical chronic myeloid leukemia, BCR/ABL-negative, not having achieved remission
  C92.21 Atypical chronic myeloid leukemia, BCR/ABL-negative, in remission
  C92.22 Atypical chronic myeloid leukemia, BCR/ABL-negative, in relapse
C92.3 Myeloid sarcoma
  C92.30 Myeloid sarcoma, not having achieved remission
  C92.31 Myeloid sarcoma, in remission
  C92.32 Myeloid sarcoma, in relapse
C92.4 Acute promyelocytic leukemia
  C92.40 Acute promyelocytic leukemia, not having achieved remission
  C92.41 Acute promyelocytic leukemia, in remission
  C92.42 Acute promyelocytic leukemia, in relapse
C92.5 Acute myelomonocytic leukemia
  C92.50 Acute myelomonocytic leukemia, not having achieved remission
  C92.51 Acute myelomonocytic leukemia, in remission
  C92.52 Acute myelomonocytic leukemia, in relapse
C92.6 Acute myeloid leukemia with 11q23-abnormality
  C92.60 Acute myeloid leukemia with 11q23-abnormality, not having achieved remission
  C92.61 Acute myeloid leukemia with 11q23-abnormality, in remission
  C92.62 Acute myeloid leukemia with 11q23-abnormality, in relapse
C92.9 Myeloid leukemia, unspecified
  C92.90 Myeloid leukemia, unspecified, not having achieved remission
  C92.91 Myeloid leukemia, unspecified, in remission
  C92.92 Myeloid leukemia, unspecified, in relapse
C92.A Acute myeloid leukemia with multilineage dysplasia
  C92.A0 Acute myeloid leukemia with multilineage dysplasia, not having achieved remission
  C92.A1 Acute myeloid leukemia with multilineage dysplasia, in remission
  C92.A2 Acute myeloid leukemia with multilineage dysplasia, in relapse
C92.Z Other myeloid leukemia
  C92.Z0 Other myeloid leukemia, not having achieved remission
  C92.Z1 Other myeloid leukemia, in remission
  C92.Z2 Other myeloid leukemia, in relapse
C93 Monocytic leukemia
C93.0 Acute monoblastic/monocytic leukemia
  C93.00 Acute monoblastic/monocytic leukemia, not having achieved remission
  C93.01 Acute monoblastic/monocytic leukemia, in remission
  C93.02 Acute monoblastic/monocytic leukemia, in relapse
C93.1 Chronic myelomonocytic leukemia
  C93.10 Chronic myelomonocytic leukemia, not having achieved remission
  C93.11 Chronic myelomonocytic leukemia, in remission
  C93.12 Chronic myelomonocytic leukemia, in relapse
C93.3 Juvenile myelomonocytic leukemia
  C93.30 Juvenile myelomonocytic leukemia, not having achieved remission
  C93.31 Juvenile myelomonocytic leukemia, in remission
  C93.32 Juvenile myelomonocytic leukemia, in relapse
C93.9 Monocytic leukemia, unspecified
  C93.90 Monocytic leukemia, unspecified, not having achieved remission
  C93.91 Monocytic leukemia, unspecified, in remission
  C93.92 Monocytic leukemia, unspecified, in relapse
C93.Z Other monocytic leukemia
  C93.Z0 Other monocytic leukemia, not having achieved remission
  C93.Z1 Other monocytic leukemia, in remission
  C93.Z2 Other monocytic leukemia, in relapse
C94 Other leukemias of specified cell type
C94.0 Acute erythroid leukemia
  C94.00 Acute erythroid leukemia, not having achieved remission
  C94.01 Acute erythroid leukemia, in remission
  C94.02 Acute erythroid leukemia, in relapse
C94.2 Acute megakaryoblastic leukemia
  C94.20 Acute megakaryoblastic leukemia, not having achieved remission
  C94.21 Acute megakaryoblastic leukemia, in remission
  C94.22 Acute megakaryoblastic leukemia, in relapse
C94.3 Mast cell leukemia
  C94.30 Mast cell leukemia, not having achieved remission
  C94.31 Mast cell leukemia, in remission
  C94.32 Mast cell leukemia, in relapse
C94.4 Acute panmyelosis with myelofibrosis
  C94.40 Acute panmyelosis with myelofibrosis, not having achieved remission
  C94.41 Acute panmyelosis with myelofibrosis, in remission
  C94.42 Acute panmyelosis with myelofibrosis, in relapse
C94.6 Myelodysplastic disease, not classified
C94.8 Other specified leukemias
  C94.80 Other specified leukemias, not having achieved remission
  C94.81 Other specified leukemias, in remission
  C94.82 Other specified leukemias, in relapse
C95 Leukemia of unspecified cell type
C95.0 Acute leukemia of unspecified cell type
  C95.00 Acute leukemia of unspecified cell type, not having achieved remission
  C95.01 Acute leukemia of unspecified cell type, in remission
  C95.02 Acute leukemia of unspecified cell type, in relapse
C95.1 Chronic leukemia of unspecified cell type
  C95.10 Chronic leukemia of unspecified cell type, not having achieved remission
  C95.11 Chronic leukemia of unspecified cell type, in remission
  C95.12 Chronic leukemia of unspecified cell type, in relapse
C95.9 Leukemia, unspecified
  C95.90 Leukemia, unspecified, not having achieved remission
  C95.91 Leukemia, unspecified, in remission
  C95.92 Leukemia, unspecified, in relapse
Generic (brand) name HCPCS code—code description FDA approved for leukemia Compendia off-label uses for leukemia Possible CPT® administration codes
aldesleukin (Proleukin) J9015 – Injection, aldesleukin, per single-use vial   96409
amifostine (Ethyol) J0207 – Injection, amifostine, 500 mg   96374
aminocaproic acid (Amicar) *J3490 – Unclassified drugs   96365, 96366
aminocaproic acid (Amicar) S0017 – Injection, aminocaproic acid, 5 g   n/a
arsenic trioxide (Trisenox) J9017 – Injection, arsenic trioxide, 1 mg   96413, 96415
asparaginase Erwinia chrysanthemi (Erwinaze) J9019 – Injection, asparaginase (Erwinaze), 1000 IU   96401
azacitidine (Vidaza) J9025 – Injection, azacitidine, 1 mg   96401, 96409, 96413
Bacillus Calmette-Guerin (BCG Vaccine) 90585 – Bacillus Calmette-Guerin vaccine (BCG) for tuberculosis, live, for percutaneous   90471, 90472
Bacillus Calmette-Guerin (Tice BCG, TheraCys) 90586 – Bacillus Calmette-Guerin vaccine (BCG) for bladder cancer, live, for intravesical use   51720
Bacillus Calmette-Guerin (Tice BCG, TheraCys) J9031 – BCG (intravesical), per installation   51720
bendamustine (Bendeka, Treanda) J9033 – Injection, bendamustine HCl, 1 mg   96409, 96413
betamethasone acetate & sodium phosphate (Celestone Soluspan) J0702 – Injection, betamethasone acetate, 3 mg, and betamethasone sodium phosphate, 3 mg   11900, 11901, 20600, 20605, 20610, 96372
blinatumomab (Blincyto) J9039 – Injection, blinatumomab, 1 microgram   96413, 96415
bosutinib (Bosulif) *C9399 – Unclassified drugs or biological (Hospital outpatient use only)   n/a
bosutinib (Bosulif) *J8999 – Prescription drug, oral, chemotherapeutic, not otherwise specified   n/a
busulfan (Busulfex) J0594 – Injection, busulfan, 1 mg   96415, 96416
busulfan (Myleran) J8510 – Busulfan, oral, 2 mg   n/a
carboplatin (Paraplatin) J9045 – Injection, carboplatin, 50 mg   96409, 96413, 96415
chlorambucil (Leukeran) *J8999 – Prescription drug, oral, chemotherapeutic, not otherwise specified   n/a
chlorambucil (Leukeran) S0172 – Chlorambucil, oral, 2 mg   n/a
cladribine (Leustatin) J9065 – Injection, cladribine, per 1 mg   96413, 96415
clofarabine (Clolar) J9027 – Injection, clofarabine, 1 mg   96413, 96415
cyclophosphamide (Cytoxan) J9070 – Cyclophosphamide, 100 mg   96409, 96413, 96415
cyclophosphamide (Cytoxan) J8530 – Cyclophosphamide, oral, 25 mg   n/a
cytarabine (Cytosar-U) J9100 – Injection, cytarabine, 100 mg   96409, 96413, 96415, 96450
dasatinib (Sprycel) *J8999 – Prescription drug, oral, chemotherapeutic, not otherwise specified   n/a
daunorubicin (Cerubidine) J9150 – Injection, daunorubicin, 10 mg   96409, 96413
decitabine (Dacogen) J0894 – Injection, decitabine, 1 mg   96413, 96415
dexamethasone (Decadron) J8540 – Dexamethasone, oral, 0.25 mg   n/a
dexamethasone (eg, Decadron) J1100 – Injection, dexamethasone sodium phosphate, 1 mg   11900, 11901, 20600, 20605, 20610, 96372, 96374
doxorubicin (Adriamycin) J9000 – Injection, doxorubicin hydrochloride, 10 mg   96409
epirubicin (Ellence) J9178 – Injection, epirubicin HCl, 2 mg   96409, 96413
etoposide (Vepesid) J8560 – Etoposide, oral, 50 mg   n/a
etoposide (Toposar) J9181 – Injection, etoposide, 10 mg   96413, 96415
filgrastim (Neupogen) J1442 – Injection, filgrastim (G-CSF), 1 microgram   96365, 96366, 96369, 96370, 96372, 96374
fludarabine (Fludara) J9185 – Injection, fludarabine phosphate, 50 mg   96413
hydrocortisone (Solu-Cortef) J1720 – Injection, hydrocortisone sodium succinate, up to 100 mg   96365, 96366, 96372, 96374
hydroxyurea (Hydrea) *J8999 – Prescription drug, oral, chemotherapeutic, not otherwise specified   n/a
hydroxyurea (Hydrea) S0176 – Hydroxyurea, oral, 500 mg   n/a
ibrutinib (Imbruvica) *J8999 – Prescription drug, oral, chemotherapeutic, not otherwise specified   n/a
idarubicin (Idamycin) J9211 – Injection, idarubicin hydrochloride, 5 mg   96409
idelalisib (Zydelig) *C9399 – Unclassified drugs or biological (Hospital outpatient use only)   n/a
idelalisib (Zydelig) *J8999 – Prescription drug, oral, chemotherapeutic, not otherwise specified   n/a
ifosfamide (Ifex) J9208 – Injection, ifosfamide, 1 gram   96413, 96415
imatinib (Gleevec) *J8999 – Prescription drug, oral, chemotherapeutic, not otherwise specified   n/a
imatinib (Gleevec) S0088 – Imatinib, 100 mg   n/a
interferon alfa-2b (Intron A) J9214 – Injection, interferon alfa-2b, recombinant, 1 million units   96372, 96401
irinotecan (Camptosar) J9206 – Injection, irinotecan, 20 mg   96413, 96415
mechlorethamine (Mustargen) J9230 – Injection, mechlorethamine hydrochloride (nitrogen mustard), 10 mg   96409
melphalan (Alkeran) J8600 – Melphalan, oral, 2 mg   n/a
melphalan (Alkeran) J9245 – Injection, melphalan hydrochloride, 50 mg   96409, 96413
mercaptopurine (Purinethol, Purixan) *J8999 – Prescription drug, oral, chemotherapeutic, not otherwise specified   n/a
mercaptopurine (Purinethol, Purixan) S0108 – Mercaptopurine, oral, 50 mg   n/a
mercaptopurine (Purixan) *C9399 – Unclassified drugs or biological (Hospital outpatient use only)   n/a
methotrexate J8610 – Methotrexate, oral, 2.5 mg   n/a
methotrexate J9250 – Methotrexate sodium, 5 mg   96372, 96374, 96401, 96409, 96450
methotrexate J9260 – Methotrexate sodium, 50 mg   96372, 96374, 96401, 96409, 96450
methylprednisolone (Depo-Medrol) J1020 – Injection, methylprednisolone acetate, 20 mg   11900, 11901, 20600, 20605, 20610, 96372
methylprednisolone acetate (Depo-Medrol) J1030 – Injection, methylprednisolone acetate, 40 mg   11900, 11901, 20600, 20605, 20610, 96372
methylprednisolone acetate (Depo-Medrol) J1040 – Injection, methylprednisolone acetate, 80 mg   11900, 11901, 20600, 20605, 20610, 96372
methylprednisolone (Medrol) J7509 – Methylprednisolone, oral, per 4 mg   n/a
methylprednisolone sodium succinate (Solu-Medrol) J2920 – Injection, methylprednisolone sodium succinate, up to 40 mg   96365, 96366, 96372, 96374
methylprednisolone sodium succinate (Solu-Medrol) J2930 – Injection, methylprednisolone sodium succinate, up to 125 mg   96365, 96366, 96372, 96374
mitoxantrone (Novantrone) J9293 – Injection, mitoxantrone hydrochloride, per 5 mg   96409, 96413
nelarabine (Arranon) J9261 – Injection, nelarabine, 50 mg   96413, 96415
nilotinib (Tasigna) *J8999 – Prescription drug, oral, chemotherapeutic, not otherwise specified   n/a
obinutuzumab (Gazyva) J9301 – Injection, obinutuzumab, 10 mg   96413, 96415
ofatumumab (Arzerra) J9302 – Injection, ofatumumab, 10 mg   96413, 96415
omacetaxine mepesuccinate (Synribo) J9262 – Injection, omacetaxine mepesuccinate, 0.01 mg   96401
pegaspargase (Oncaspar) J9266 – Injection, pegaspargase, per single-dose vial   96401, 96413, 96415
pentostatin (Nipent) J9268 – Injection, pentostatin, per 10 mg   96409, 96413
ponatinib (Iclusig) *C9399 – Unclassified drugs or biological (Hospital outpatient use only)   n/a
ponatinib (Iclusig) *J8999 – Prescription drug, oral, chemotherapeutic, not otherwise specified   n/a
prednisolone (eg, Millipred) J7510 – Prednisolone, oral, per 5 mg   n/a
prednisone (eg, Deltasone) J7512 – Prednisone, immediate release or delayed release, oral, 1 mg   n/a
rituximab (Rituxan) J9310 – Injection, rituximab, 100 mg   96413, 96415
sodium phosphate P-32 A9563 – Sodium phosphate P-32, therapeutic, per millicurie   79101
temozolomide (Temodar) J8700 – Temozolomide, oral, 5 mg   n/a
teniposide (Vumon) Q2017 – Injection, teniposide, 50 mg   96413, 96415
topotecan (Hycamtin) J9351 – Injection, topotecan, 0.1 mg   96413
venetoclax (Venclexta) *C9399 – Unclassified drugs or biological (Hospital outpatient use only)   n/a
venetoclax (Venclexta) *J8999 – Prescription drug, oral, chemotherapeutic, not otherwise specified   n/a
vinCRIStine (Vincasar PFS) J9370 – Vincristine sulfate, 1 mg   96409
vinCRIStine liposome (Marqibo) J9371 – Injection, vincristine sulfate liposome, 1 mg   96413
zidovudine (Retrovir) *J8499 – Prescription drug, oral, nonchemotherapeutic, not otherwise specified   n/a
zidovudine (Retrovir) S0104 – Zidovudine, oral, 100 mg   n/a
*When billing a nonclassified medication using a CMS 1500 claim form you must include both the HCPCS code in Item 24D and the drug name, strength, and NDC (National Drug Code) in Box 19 or Item 24A (shaded area) in order to ensure appropriate reimbursement. Please note: Check with payer regarding correct placement of medication information.
References
• HCPCS Level II Expert 2016
Current Procedural Terminology (CPT®) 2016
CPT Copyright © 2016 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association
ICD-10-CM for Professionals Volumes 1 & 2 2016
• FDA-approved indication (product Prescribing Information)
• Compendia references available upon request
• www.ReimbursementCodes.com powered by RJ Health Systems International, LLC, Rocky Hill, CT
• CMS (Centers for Medicare & Medicaid Services)
G-CSF indicates granulocyte colony-stimulating factor; HCPCS, Healthcare Common Procedure Coding System.
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