2026 ICD-10-CM Diagnosis Code C86.01Extranodal NK/T-cell lymphoma, nasal type, in remission
ICD-10-CM Codes›C00–D49›C81-C96›C86
- Billable — Valid for Submission
- CC — Complication or Comorbidity
- Risk Adjusts — HCC 20
- Chronic Condition
C86.01 is a billable ICD-10-CM diagnosis code for extranodal NK/T-cell lymphoma, nasal type, in remission. 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, 974 through 976. 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 70 closely related codes. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Non-Hodgkin lymphoma in remission.
For Medicare Advantage risk adjustment, C86.01 maps to CMS-HCC Category 20 (Lung and Other Severe Cancers) under the V28 model, adding a risk factor of about 1.136 for a community, non-dual, aged beneficiary in payment year 2026.
Code Identity
Code Classification
Medicare Risk Adjustment (HCC)Billing
C86.01 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.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Code History & ChangesHistory
Replacement C86.01 replaces the following previously assigned code(s):
- Z85.72 - Personal history of non-Hodgkin lymphomas
Questions About C86.01Overview
What is the ICD-10 code for extranodal NK/T-cell lymphoma, nasal type, in remission?
The ICD-10-CM code for extranodal NK/T-cell lymphoma, nasal type, in remission is C86.01 (sometimes written as C8601). It is billable on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
Is C86.01 (Extranodal NK/T-cell lymphoma, nasal type) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report extranodal NK/T-cell lymphoma, nasal type, in remission on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What MS-DRG does C86.01 group to?
When extranodal NK/T-cell lymphoma, nasal type, in remission 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, 974, 975, 976, with relative weights from 0.8945 to 5.8648 depending on complications. Higher weights mean higher Medicare reimbursement.
Is C86.01 a CC or MCC?
CMS lists C86.01 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 70 closely related codes in its exclusion list.
What HCC is C86.01?
C86.01 (extranodal NK/T-cell lymphoma, nasal type, in remission) maps to CMS-HCC Category 20 (Lung and Other Severe Cancers), commonly written as HCC 20, 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 C86.01 risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, C86.01 adds a risk adjustment factor of about 1.136 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.672 to 1.214 depending on the payment segment). A more severe related category (HCC 17, HCC 18, and HCC 19) supersedes it when both are reported. See the full factor table on the HCC 20 category page.
