2026 ICD-10-CM Diagnosis Code C81.11Nodular sclerosis Hodgkin lymphoma, lymph nodes of head, face, and neck
ICD-10-CM Codes›C00–D49›C81-C96›C81
- Billable — Valid for Submission
- CC — Complication or Comorbidity
- Risk Adjusts — HCC 21
- Chronic Condition
C81.11 is a billable ICD-10-CM diagnosis code for nodular sclerosis Hodgkin lymphoma, lymph nodes of head, face, and neck. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 11 through 13, 820 through 825, 840 through 842. As a secondary diagnosis, it counts as a complication or comorbidity (CC) and moves an inpatient stay to a higher severity level within its MS-DRG family. It does not count, however, when the principal diagnosis is one of 80 closely related codes. Coders also document this condition as hodgkin disease of lymph nodes of head. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Hodgkin lymphoma.
For Medicare Advantage risk adjustment, C81.11 maps to CMS-HCC Category 21 (Lymphoma and Other Cancers) under the V28 model, adding a risk factor of about 0.671 for a community, non-dual, aged beneficiary in payment year 2026.
Code Identity
Code Classification
Medicare Risk Adjustment (HCC)Billing
C81.11 maps to a payment category in the CMS-HCC model used to risk-adjust Medicare Advantage payments. Weights are the published community factors for payment year 2026.
Source: CMS Payment Year 2026 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Hodgkin disease of lymph nodes of head
- Hodgkin disease of lymph nodes of neck
- Hodgkin disease, nodular sclerosis of lymph nodes of head
- Hodgkin disease, nodular sclerosis of lymph nodes of head and neck
- Hodgkin disease, nodular sclerosis of lymph nodes of neck
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
Hodgkin Lymphoma
Hodgkin lymphoma, also called Hodgkin disease, is a type of cancer that develops in the lymph system. Your lymph system is part of your immune system. It helps protect your body from infection and disease.
The full article covers:
- What is Hodgkin lymphoma?
- What causes Hodgkin lymphoma?
- Who is more likely to develop Hodgkin lymphoma?
- What are the symptoms of Hodgkin lymphoma?
- How is Hodgkin lymphoma diagnosed?
- What are the treatments for Hodgkin lymphoma?
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert C81.11 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About C81.11Overview
Is C81.11 (Nodular sclerosis Hodgkin lymphoma) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report nodular sclerosis Hodgkin lymphoma, lymph nodes of head, face, and neck on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What MS-DRG does C81.11 group to?
When nodular sclerosis Hodgkin lymphoma, lymph nodes of head, face, and neck is the principal diagnosis on an inpatient stay, it groups to MS-DRG 11, 12, 13, 820, 821, 822, 823, 824, 825, 840, 841, 842, with relative weights from 1.0104 to 5.8648 depending on complications. Higher weights mean higher Medicare reimbursement.
Is C81.11 a CC or MCC?
CMS lists C81.11 as a CC (complication or comorbidity) for FY 2026. Reported as a secondary diagnosis, it moves the inpatient stay to a higher-weighted DRG within its severity family. It does not count when the principal diagnosis is one of the 80 closely related codes in its exclusion list.
What is the ICD-9 equivalent of C81.11?
Under the General Equivalence Mappings, nodular sclerosis Hodgkin lymphoma, lymph nodes of head, face, and neck converts to ICD-9-CM 201.51 (hodg nodul sclero head). The mapping is a direct match.
What HCC is C81.11?
C81.11 (nodular sclerosis Hodgkin lymphoma, lymph nodes of head, face, and neck) maps to CMS-HCC Category 21 (Lymphoma and Other Cancers), commonly written as HCC 21, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2026. It mapped to HCC 10 under the retired V24 model. It also maps in the PACE (CMS-HCC V22), ESRD (V21), and ESRD (V24) models. In the Part D prescription drug model it maps to RxHCC 21.
Does C81.11 risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, C81.11 adds a risk adjustment factor of about 0.671 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.493 to 0.739 depending on the payment segment). A more severe related category (HCC 17, HCC 18, HCC 19, and HCC 20) supersedes it when both are reported. See the full factor table on the HCC 21 category page.
