C49.4

C49.4: Malignant neoplasm of connective and soft tissue of abdomen

Billable / specific codeICD-10-CM

C49.4 is a billable, specific ICD-10-CM code for malignant neoplasm of connective and soft tissue of abdomen. It is valid for submission on a claim.

Check C49.4 with the rest of the claim: free scrubber

Inclusion terms

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

Malignant neoplasm of abdominal wall
Malignant neoplasm of hypochondrium

Excludes1 inherited from the categories above C49.4

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 C49.4

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.-)

Risk adjustment

C49.4 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:

HCC 23 Prostate, Breast, and Other Cancers and Tumors0.186 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

C49.4 is named in 58 Medicare coverage policies: 58 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A52370Billing and Coding: Bevacizumab and biosimilars
A52450Billing and Coding: Paclitaxel (e.g., Taxol®/Abraxane ™)
A52479Oral Anticancer Drugs - Policy Article
A52480Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) - Policy Article

Code history

Unchanged in every release from FY2024 to FY2027.