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ICD-10 Guide
DiagnosesAcute Lymphocytic Leukemia

Acute Lymphocytic Leukemia

ICD-10 Coding for Acute Lymphocytic Leukemia(C91.00, C91.01, C91.02)

PRIMARY SPECIALTYOncology
COMPLEXITYHigh
LAST UPDATED09/15/2025
Sam Tuffun, PT, DPT
Physical Therapist | Medical Coding & Billing Contributor

Diagnosis Overview

What is Acute Lymphocytic Leukemia?
Essential facts and insights about Acute Lymphocytic Leukemia

Key Clinical Considerations:

  • Presence of symptoms such as fatigue, fever, easy bruising or bleeding, and frequent infections.
  • Laboratory findings including elevated white blood cell count, presence of immature lymphoblasts in the blood or bone marrow, and low red blood cell and platelet counts.
  • Physical examination may reveal splenomegaly, lymphadenopathy, or pallor.
  • Imaging studies may show lymphadenopathy or splenomegaly but are not typically required for diagnosis.
  • Staging information includes classification based on the presence of leukemic cells in the blood, bone marrow, and extramedullary sites.

Clinical Information

Clinical Criteria & Documentation Requirements

  • Complete medical history and physical examination findings must be documented.
  • Specific terminology such as 'acute lymphoblastic leukemia' or 'lymphoid blast crisis' must be used.
  • Examples include documenting the patient's presenting symptoms, laboratory results, and treatment plans.
  • Medical necessity must be established through documentation of symptoms and diagnostic findings.
  • Quality measures may include documentation of treatment response and follow-up care.

Coding Guidelines

Usage Guidelines & Examples

  • Use C91.00 for acute lymphocytic leukemia, not otherwise specified, when no further specification is available.
  • Do not use this code for chronic lymphocytic leukemia (C91.1) or other types of leukemia.
  • C91.01 and C91.02 are used for acute lymphoblastic leukemia with specific subtypes (B-cell and T-cell).
  • Common errors include misclassifying acute lymphocytic leukemia as chronic or failing to specify the subtype.
  • In complex cases, ensure to document the specific subtype and any relevant treatment history.

Code Exclusions

Important Exclusions

  • Chronic lymphocytic leukemia (C91.1) is explicitly excluded from this diagnosis.
  • Use C91.1 for patients with chronic forms of lymphocytic leukemia.
  • Conditions are excluded due to differing pathophysiology and treatment approaches.
  • Common mistakes include misdiagnosing acute lymphocytic leukemia as chronic lymphocytic leukemia.
  • Related but distinct conditions include acute myeloid leukemia (C92) and lymphoblastic lymphoma (C83.0).

Related ICD-10 Codes

Primary Codes
C91.00
Acute lymphocytic leukemia, not otherwise specified
C91.01
Acute lymphoblastic leukemia, B-cell type
C91.02
Acute lymphoblastic leukemia, T-cell type
Ancillary Codes
Z51.12
Differential Codes
C83.0
C91.02
C91.01

Related CPT Codes

CPT codes will be available in a future update.

Specialty Focus

Primary Specialty

Oncology

Specialty Applications

  • Patients diagnosed with acute lymphoblastic leukemia.
  • Commonly affects children and young adults, but can occur in older adults.
  • Clinical settings include inpatient oncology units and outpatient hematology clinics.
  • Oncology specialty-specific applications for treatment and management.
  • Used in contexts of chemotherapy, radiation therapy, and stem cell transplantation.

Coding Complexity

High Complexity

This diagnosis requires careful attention to:

  • Comprehensive clinical documentation
  • Accurate code selection based on clinical criteria
  • Proper exclusion considerations
  • Specialty-specific coding guidelines

Documentation

Documentation Templates

Template 1

Template: 'Patient diagnosed with acute lymphocytic leukemia based on clinical findings and laboratory results.'

Template 2

Template: 'Clinical presentation consistent with acute lymphoblastic leukemia including fatigue and lymphadenopathy.'

Template 3

Template: 'Diagnostic criteria for acute lymphocytic leukemia met as evidenced by elevated lymphoblasts in the bone marrow.'

Template 4

Template: 'Treatment plan initiated for acute lymphocytic leukemia with chemotherapy regimen outlined.'

Template 5

Template: 'Follow-up care for acute lymphocytic leukemia including monitoring of blood counts and treatment response.'

Billing Information

Billing Considerations

  • Ensure proper documentation for billing
  • Verify code specificity requirements
  • Check for any additional codes needed
  • Review payer-specific guidelines

Common Issues

  • Insufficient clinical documentation
  • Incorrect code selection
  • Missing supporting diagnoses
  • Timing and frequency documentation

Frequently Asked Questions

What documentation is required for this diagnosis?

Documentation must include clinical findings, laboratory results, and treatment plans.

How does this differ from similar diagnoses?

Acute lymphocytic leukemia is characterized by the rapid proliferation of lymphoblasts, unlike chronic forms.

What are common billing considerations?

Ensure accurate coding to reflect the specific type of leukemia for optimal reimbursement.

What procedures are typically associated?

Common CPT codes include those for chemotherapy administration and bone marrow biopsy.

Are there any quality reporting implications?

Quality measures may include tracking treatment response and adherence to clinical guidelines.