Tabular list notes for C91.61
The tabular list has no notes on C91.61 itself; the notes below apply from its parent headings.
Inherited from C91 (Lymphoid leukemia)
- Excludes1 (never coded together)
- personal history of leukemia (Z85.6)
MS-DRG grouping when C91.61 is the principal diagnosis
The final group also depends on procedures, secondary diagnoses and discharge status; the MS-DRG lookup for C91.61 shows the full grouping logic.
CC/MCC status and inpatient edits
As a secondary diagnosis, C91.61 is a CC under MS-DRG v44, unless the principal diagnosis is one of the 113 codes in its exclusion list. Check C91.61 against a principal diagnosis.
- Present on admission: a POA indicator is required on inpatient claims.
CMS-HCC V28 risk adjustment
In the PY2027 mapping, C91.61 maps to HCC 19 (Myelodysplastic Syndromes, Multiple Myeloma, and Other Cancers). The HCC lookup shows the RAF weight and the hierarchy.
LCD billing and coding articles that list C91.61
23 current Medicare billing and coding articles list C91.61 among the diagnoses that support medical necessity for the services they cover.
- Oral Anticancer Drugs - Policy Article A52479
- Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) - Policy Article A52480
- Billing and Coding: Biomarkers for Oncology A52986
- Billing and Coding: Cardiac Blood Pool Imaging (Multiple Gated Acquisition Scanning- MUGA, Ventriculography) When Performed in Conjunction with Cardiotoxic Chemotherapy A54768
- Billing and Coding: Lab: Flow Cytometry A55717
- Billing and Coding: CT of the Abdomen and Pelvis A56421
- Billing and Coding: Erythropoiesis Stimulating Agents (ESA) A56462
- Billing and Coding: Flow Cytometry A56464
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Frequently asked questions
What does ICD-10-CM C91.61 mean?
C91.61 means prolymphocytic leukemia of T-cell type, in remission. It is one of 25 billable codes under C91, lymphoid leukemia.
Which MS-DRG does C91.61 group to?
As the principal diagnosis, C91.61 groups to MS-DRG 820 Lymphoma and Leukemia with Major O.R. Procedures with MCC, MS-DRG 821 Lymphoma and Leukemia with Major O.R. Procedures with CC, MS-DRG 822 Lymphoma and Leukemia with Major O.R. Procedures without CC/MCC (MDC 17 MDC 17: Myeloproliferative Diseases and Disorders, Poorly Differentiated Neoplasms) under MS-DRG v44, before procedures and secondary diagnoses are applied.
Does C91.61 map to an HCC?
Yes: HCC 19, Myelodysplastic Syndromes, Multiple Myeloma, and Other Cancers, in the PY2027 CMS-HCC V28 mapping.
Is C91.61 a CC or MCC?
C91.61 is a CC under MS-DRG v44; 113 principal diagnoses exclude it.
Sources
Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-10. Verify against the primary file before billing or contracting decisions. The reference methodology explains how each figure is computed from these files.
- ICD-10-CM FY2027 tabular order file (category titles)Version FY2027 · effective 2026-10-01 · file icd10cm_order_2027.txtSHA-256 38981fb2c1226e2b…
- ICD-10-CM FY2027 tabular list (chapter titles and ranges)Version FY2027 · effective 2026-10-01 · file 2027-code-tables-tabular-index.zipSHA-256 37baa476323714be…
- ICD-10-CM FY2027 code descriptions addenda (codes added, deleted and revised)Version FY2027 · effective 2026-10-01 · file icd10cm_codes_addenda_2027.txtSHA-256 cfba025073235af4…
- ICD-10 MS-DRG Definitions Manual v44 (text)Version v44 · effective 2026-10-01 · file fy2027-fr-icd10-ms-drg-definitions-manual-files-v44.zipSHA-256 ae4f6c11727fe91f…
- IPPS FY2027 Tables 6A-6K: new, invalid and revised ICD-10-CM/PCS codes, CC/MCC list changes and CC exclusionsVersion FY2027 (final rule; not reissued by CN3) · effective 2026-10-01 · file fy2027-ipps-fr-tables-6a-6k.zipSHA-256 ca0af87b0869a405…
- ICD-10-CM FY2027 POA-exempt codes (full list, additions, deletions and revisions)Version FY2027 · effective 2026-10-01 · file 2027-poa-exempt-codes.zipSHA-256 03f55091045024d0…
- ICD-10-CM to CMS-HCC V28 mappings, payment year 2027 initialVersion PY2027 initial ICD-10-CM mappings (dates of service 2026) · effective 2027-01-01 · file 2027 Initial ICD-10-CM Mappings.csvSHA-256 9c260b06d0dd2806…
- Medicare Coverage Database, current Billing and Coding Articles exportVersion MCD release 2026-10-08 · effective 2026-10-04 · file article.csvSHA-256 5e95c4a8ac3664be…
Disclaimer
The descriptor and notes are reproduced from the FY2027 ICD-10-CM files; MS-DRG, CC/MCC and HCC facts come from the CMS FY2027 and PY2027 tables. Code from the medical record and the ICD-10-CM Official Guidelines. Not legal, clinical or billing advice.
Found a figure that does not match the CMS file? Report a data correction with the CMS file and the value you expected; the request reaches the editorial team through the contact form.