C49.3

C49.3: Malignant neoplasm of connective and soft tissue of thorax

Billable / specific codeICD-10-CM

C49.3 is a billable, specific ICD-10-CM code for malignant neoplasm of connective and soft tissue of thorax. It is valid for submission on a claim.

Check C49.3 with the rest of the claim: free scrubber

Excludes1: never code together

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

malignant neoplasm of breast (C50.-)
malignant neoplasm of heart (C38.0)
malignant neoplasm of mediastinum (C38.1-C38.3)
malignant neoplasm of thymus (C37)

Inclusion terms

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

Malignant neoplasm of axilla
Malignant neoplasm of diaphragm
Malignant neoplasm of great vessels

Excludes1 inherited from the categories above C49.3

A category’s note binds every code beneath it.

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 C49.3

Not part of this code, but both may be coded when both are present.

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 C49.3

Their own Excludes1 notes name this code, so the conflict is not listed above.

C38.0Malignant neoplasm of heart

Risk adjustment

C49.3 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. Look up the whole chart to see which of its HCCs the hierarchy would zero.

Medicare coverage

C49.3 is named in 55 Medicare coverage policies: 55 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

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Code history

Unchanged in every release from FY2024 to FY2027.