2027 ICD-10-CM Diagnosis Code C91.A2Mature B-cell leukemia Burkitt-type, in relapse

ICD-10-CM Codes›C00–D49›C81-C96›C91

ICD-10-CM C91.A2
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

C91.A2 is a billable ICD-10-CM diagnosis code for mature B-cell leukemia Burkitt-type, in relapse. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 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 113 closely related codes. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Leukemia - all other types.

For Medicare Advantage risk adjustment, C91.A2 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 2027.

Code Identity

ICD-10-CM Code
C91.A2
Billable Status
Yes — Valid for Submission
Code Describes
Mature B-cell leukemia Burkitt-type, in relapse
Short Description
Mature B-cell leukemia Burkitt-type, in relapse
Same as the full description in the CMS dataset.
Parent Code
Mature B-cell leukemia Burkitt-type

Code Classification

ChapterC00–D49Neoplasms
SectionC81-C96Malignant neoplasms of lymphoid, hematopoietic and related tissue
CategoryC91Lymphoid leukemia
This CodeC91.A2Mature B-cell leukemia Burkitt-type, in relapse

Medicare Risk Adjustment (HCC)Billing

C91.A2 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 2027.

CMS-HCC V28 Category (Payment Model)
HCC 20— Lung and Other Severe Cancers
Payment HCC · PY 2027 one of 233 ICD-10-CM codes in this category
Risk Adjustment Factor (RAF) Weight
+1.136
community, non-dual, aged · ranges 0.672–1.214 across segments
Hierarchy
Superseded by HCC 17, HCC 18, and HCC 19
a more severe related category takes the payment when both are reported
Prior Model (CMS-HCC V24)
HCC 10
V24 retired V28 pays 100% of MA risk scores since PY 2026
Other CMS Models
PACE (CMS-HCC V22): HCC 10 · ESRD (V21): HCC 10 · ESRD (V24): HCC 10
ESRD V21 weights: 0.136 dialysis, 0.451–0.668 functioning graft · ESRD V24 weights: 0.111 dialysis, 0.467–0.780 functioning graft
Part D (RxHCC)
RxHCC 19 — Leukemias and Other Hematologic Cancers
also risk-adjusts in the Part D prescription drug model (V08)

Source: CMS Payment Year 2027 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.

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to C91.A2: its own notes plus those printed at C91.A, C91, block C81-C96, and Chapter 2. A note printed at a category, block or chapter applies to every code under it.

Excludes1

Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.

From C91.A Mature B-cell leukemia Burkitt-type applies to 3 codes
From C91 Lymphoid leukemia applies to 27 codes
  • personal history of leukemia (Z85.6)

Excludes2

Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.

From Block C81-C96 Malignant neoplasms of lymphoid, hematopoietic and related tissue applies to 533 codes
  • Kaposi's sarcoma of lymph nodes (C46.3)
  • secondary and unspecified neoplasm of lymph nodes (C77.-)
  • secondary neoplasm of bone marrow (C79.52)
  • secondary neoplasm of spleen (C78.89)

Notes

General instructions on how these codes are used.

From Chapter 2 (C00-D49) Neoplasms applies to 1,730 codes
  • Functional activity
  • All neoplasms are classified in this chapter, whether they are functionally active or not. An additional code from Chapter 4 may be used, to identify functional activity associated with any neoplasm.
  • Morphology [Histology]
  • Chapter 2 classifies neoplasms primarily by site (topography), with broad groupings for behavior, malignant, in situ, benign, etc. The Table of Neoplasms should be used to identify the correct topography code. In a few cases, such as for malignant melanoma and certain neuroendocrine tumors, the morphology (histologic type) is included in the category and codes.
  • Primary malignant neoplasms overlapping site boundaries
  • A primary malignant neoplasm that overlaps two or more contiguous (next to each other) sites should be classified to the subcategory/code .8 ('overlapping lesion'), unless the combination is specifically indexed elsewhere. For multiple neoplasms of the same site that are not contiguous, such as tumors in different quadrants of the same breast, codes for each site should be assigned.
  • Malignant neoplasm of ectopic tissue
  • Malignant neoplasms of ectopic tissue are to be coded to the site mentioned, e.g., ectopic pancreatic malignant neoplasms are coded to pancreas, unspecified (C25.9).

Source: CMS ICD-10-CM Tabular List. How to read instructional notes.

Referenced in Other NotesGuidance

Instructional notes printed at other codes that name C91.A2, its category, or a range that includes it.

Applicable To 2

These notes mention C91.A2.

  • Z80.6 Family history of leukemia
    Conditions classifiable to C91-C95 names C91-C95, which includes this code
  • Z85.6 Personal history of leukemia
    Conditions classifiable to C91-C95 names C91-C95, which includes this code

Excludes1 5

These codes carry an Excludes1 note naming C91.A2: they are not reported together with it, unless the two conditions are unrelated.

  • C83.7 Burkitt lymphoma
    mature B-cell leukemia Burkitt type (C91.A-) names C91.A-, which includes this code
  • D72.825 Bandemia
    leukemia (C91.-, C92.-, C93.-, C94.-, C95.-) names C91.-, which includes this code
  • D72.8 Other specified disorders of white blood cells
    leukemia (C91-C95) names C91-C95, which includes this code
  • T66 Radiation sickness, unspecified
    leukemia (C91-C95) names C91-C95, which includes this code
  • Z85.6 Personal history of leukemia
    leukemia in remission C91.0-C95.9 with 5th character 1 names C91.0-C95.9, which includes this code

Code First 3

These codes say to code first a condition named in the note, and C91.A2 is one of the conditions named.

  • M36.1 Arthropathy in neoplastic disease
    leukemia (C91-C95) names C91-C95, which includes this code
  • N16 Renal tubulo-interstitial disorders in diseases classified elsewhere
    leukemia (C91-C95) names C91-C95, which includes this code
  • R50.81 Fever presenting with conditions classified elsewhere
    leukemia (C91-C95) names C91-C95, which includes this code

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR NEO064
Leukemia - all other types
Default principal diagnosis: inpatient Yes · outpatient Yes

Clinical InformationClinical

  • Recurrent Burkitt Leukemia

    the reemergence of burkitt leukemia after a period of remission.
  • Leukemia, Lymphoid

    leukemia associated with hyperplasia of the lymphoid tissues and increased numbers of circulating malignant lymphocytes and lymphoblasts.

Patient EducationClinical

Lymphoma

Lymphoma is a cancer of a part of the immune system called the lymph system. There are many types of lymphoma. One type is Hodgkin disease. The rest are called non-Hodgkin lymphomas.

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert C91.A2 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
204.82 Oth lym leuk in relapse
Approximate The match is approximate rather than exact.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About C91.A2Overview

What is the ICD-10 code for mature B-cell leukemia Burkitt-type, in relapse?

The ICD-10-CM code for mature B-cell leukemia Burkitt-type, in relapse is C91.A2 (sometimes written as C91A2). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is C91.A2 (Mature B-cell leukemia Burkitt-type) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report mature B-cell leukemia Burkitt-type, in relapse on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does C91.A2 group to?

When mature B-cell leukemia Burkitt-type, in relapse is the principal diagnosis on an inpatient stay, it groups to MS-DRG 841, 821, 822, 825, 842, 824, 840, 820, 823, with relative weights from 0.9948 to 6.2454 depending on complications. Higher weights mean higher Medicare reimbursement.

Is C91.A2 a CC or MCC?

CMS lists C91.A2 as a CC (complication or comorbidity) for FY 2027. 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 113 closely related codes in its exclusion list.

Can C91.A2 be reported with a code from C83.7?

Not as a rule. The Excludes1 note at C91.A, which applies to C91.A2, lists "Burkitt lymphoma (C83.7-)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).

What HCC is C91.A2?

C91.A2 (mature B-cell leukemia Burkitt-type, in relapse) 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 2027. 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 19.

Does C91.A2 risk-adjust for Medicare Advantage payment?

Yes. When documented and reported on a Medicare Advantage encounter, C91.A2 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.