2027 ICD-10-CM Diagnosis Code C95.10Chronic leukemia of unspecified cell type not having achieved remission
ICD-10-CM Codes›C00–D49›C81-C96›C95
- Billable — Valid for Submission
- CC — Complication or Comorbidity
- Risk Adjusts — HCC 22
- Chronic Condition
C95.10 is a billable ICD-10-CM diagnosis code for chronic leukemia of unspecified cell type not having achieved remission. 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. Coders also document this condition as chronic leukemia. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Leukemia - all other types.
For Medicare Advantage risk adjustment, C95.10 maps to CMS-HCC Category 22 (Bladder, Colorectal, and Other Cancers) under the V28 model, adding a risk factor of about 0.363 for a community, non-dual, aged beneficiary in payment year 2027.
Code Identity
Code Classification
Medicare Risk Adjustment (HCC)Billing
C95.10 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.
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.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Chronic leukemia
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to C95.10: its own notes plus those printed at C95, block C81-C96, and Chapter 2. A note printed at a category, block or chapter applies to every code under it.
Applicable To
Conditions this code is used for: synonyms of the title or, for "other specified" codes, the conditions assigned to it. The list is not exhaustive.
- Chronic leukemia of unspecified cell type with failed remission
- Chronic leukemia NOS
Excludes1
Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.
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.
Notes
General instructions on how these codes are used.
- 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 C95.10, its category, or a range that includes it.
Applicable To 2
These notes mention C95.10.
Excludes1 5
These codes carry an Excludes1 note naming C95.10: they are not reported together with it, unless the two conditions are unrelated.
- C95.0 Acute leukemia of unspecified cell typeacute exacerbation of unspecified chronic leukemia (C95.10)
- D72.825 Bandemialeukemia (C91.-, C92.-, C93.-, C94.-, C95.-) names C95.-, which includes this code
- D72.8 Other specified disorders of white blood cells
- T66 Radiation sickness, unspecified
- Z85.6 Personal history of leukemia
Code First 3
These codes say to code first a condition named in the note, and C95.10 is one of the conditions named.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
Leukemia
Leukemia is a term for cancers of the blood cells. Leukemia starts in blood-forming tissues such as the bone marrow. Your bone marrow makes the cells which will develop into white blood cells, red blood cells, and platelets. Each type of cell has a different job:
The full article covers:
- What is leukemia?
- What are the types of leukemia?
- What causes leukemia?
- Who is at risk for leukemia?
- What are the symptoms of leukemia?
- How is leukemia diagnosed?
- What are the treatments for leukemia?
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert C95.10 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About C95.10Overview
Is C95.10 (Chronic leukemia of unspecified cell type) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report chronic leukemia of unspecified cell type not having achieved remission on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does C95.10 group to?
When chronic leukemia of unspecified cell type not having achieved remission 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 C95.10 a CC or MCC?
CMS lists C95.10 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 C95.10 be reported with Z85.6?
Not as a rule. The Excludes1 note at C95, which applies to C95.10, lists "personal history of leukemia (Z85.6)". 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 is the ICD-9 equivalent of C95.10?
Under the General Equivalence Mappings, chronic leukemia of unspecified cell type not having achieved remission converts to ICD-9-CM 208.10 (ch leu un cl wo ach rmsn). The mapping is a direct match.
What HCC is C95.10?
C95.10 (chronic leukemia of unspecified cell type not having achieved remission) maps to CMS-HCC Category 22 (Bladder, Colorectal, and Other Cancers), commonly written as HCC 22, 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 C95.10 risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, C95.10 adds a risk adjustment factor of about 0.363 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.314 to 0.410 depending on the payment segment). A more severe related category (HCC 17, HCC 18, HCC 19, HCC 20, and HCC 21) supersedes it when both are reported. See the full factor table on the HCC 22 category page.
