Is C49.0 a billable ICD-10-CM code?

Yes. C49.0 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does C49.0 sit in the tabular list?

Neoplasms (C00-D49), in the block Malignant neoplasms of mesothelial and soft tissue (C45-C49).

What cannot be coded together with C49.0?

C49.0 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above C49.0 (C49) and apply to it just the same.

C49.0

C49.0 — Malignant neoplasm of connective and soft tissue of head, face and neck

Billable / specific codeICD-10-CM

C49.0 is a billable, specific ICD-10-CM code for malignant neoplasm of connective and soft tissue of head, face and neck. It is valid for submission on a claim.

Excludes1 — never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

connective tissue of orbit (C69.6-)

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Malignant neoplasm of connective tissue of ear
Malignant neoplasm of connective tissue of eyelid

Excludes1 inherited from the categories above C49.0

These are not written on C49.0, but they bind it: a note on a category applies to every code beneath it. Billing C49.0 with anything listed here is a denial.

Written on C49 — Malignant neoplasm of other connective and soft tissue

malignant neoplasm of cartilage (of):
articular (C40-C41)
larynx (C32.3)
nose (C30.0)
malignant neoplasm of connective tissue of breast (C50.-)

Excludes2 inherited from the categories above C49.0

Also inherited, and the opposite of Excludes1: these conditions are not part of C49.0, but a patient can have both, so you may code both.

Written on C49 — Malignant neoplasm of other connective and soft tissue

Kaposi's sarcoma of soft tissue (C46.1)
malignant neoplasm of heart (C38.0)
malignant neoplasm of peripheral nerves and autonomic nervous system (C47.-)
malignant neoplasm of peritoneum (C48.2)
malignant neoplasm of retroperitoneum (C48.0)
malignant neoplasm of uterine ligament (C57.3)
mesothelioma (C45.-)

Other codes that can never be billed with C49.0

These codes carry an Excludes1 note pointing at C49.0. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading C49.0 alone.

C30.1Malignant neoplasm of middle ear
C41Malignant neoplasm of bone and articular cartilage of other and unspecified sites
C69Malignant neoplasm of eye and adnexa
C44.2Other and unspecified malignant neoplasm of skin of ear and external auricular canal
C44.1Other and unspecified malignant neoplasm of skin of eyelid, including canthus

Risk adjustment

C49.0 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:

HCC 21 Lymphoma and Other Cancers0.671 RAF

Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.

Medicare coverage

C49.0 is named in 100 Medicare coverage policies — 100 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

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Code history

C49.0 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share C49. If C49.0 is not quite right, the correct code is usually one of these.

Questions about C49.0

Is C49.0 a billable ICD-10-CM code?: Yes. C49.0 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does C49.0 sit in the tabular list?: Neoplasms (C00-D49), in the block Malignant neoplasms of mesothelial and soft tissue (C45-C49).
What cannot be coded together with C49.0?: C49.0 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above C49.0 (C49) and apply to it just the same.