C49.0 — Malignant neoplasm of connective and soft tissue of head, face and neck
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
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.
- C69Malignant neoplasm of eye and adnexa
- C30.1Malignant neoplasm of middle ear
- C41Malignant neoplasm of bone and articular cartilage of other and unspecified sites
- C44.1Other and unspecified malignant neoplasm of skin of eyelid, including canthus
- C44.2Other and unspecified malignant neoplasm of skin of ear and external auricular canal
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 92 Medicare coverage policies — 92 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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Related codes at this level
Codes that share C49. If C49.0 is not quite right, the correct code is usually one of these.
- C49.1Malignant neoplasm of connective and soft tissue of upper limb, including shoulder
- C49.2Malignant neoplasm of connective and soft tissue of lower limb, including hip
- C49.3Malignant neoplasm of connective and soft tissue of thorax
- C49.4Malignant neoplasm of connective and soft tissue of abdomen
- C49.5Malignant neoplasm of connective and soft tissue of pelvis
- C49.6Malignant neoplasm of connective and soft tissue of trunk, unspecified
- C49.8Malignant neoplasm of overlapping sites of connective and soft tissue
- C49.9Malignant neoplasm of connective and soft tissue, unspecified
- C49.AGastrointestinal stromal tumor
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 an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.