Is C49.A1 a billable ICD-10-CM code?

Yes. C49.A1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does C49.A1 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.A1?

C49.A1 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.A1 (C49) and apply to it just the same.

C49.A1

C49.A1 — Gastrointestinal stromal tumor of esophagus

Billable / specific codeICD-10-CM

C49.A1 is a billable, specific ICD-10-CM code for gastrointestinal stromal tumor of esophagus. It is valid for submission on a claim.

Excludes1 inherited from the categories above C49.A1

These are not written on C49.A1, but they bind it: a note on a category applies to every code beneath it. Billing C49.A1 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.A1

Also inherited, and the opposite of Excludes1: these conditions are not part of C49.A1, 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.-)

Risk adjustment

C49.A1 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.

Medicare coverage

C49.A1 is named in 69 Medicare coverage policies — 69 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A52479Oral Anticancer Drugs - Policy Article
A52479Oral Anticancer Drugs - Policy Article
A52480Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) - Policy Article
A52986Billing and Coding: Biomarkers for Oncology

How C49.A1 is indexed

Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to C49.A1.

Tumor›stromal›gastrointestinal›esophagus
Tumor›stromal›gastrointestinal›malignant›esophagus

Code history

C49.A1 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.A. If C49.A1 is not quite right, the correct code is usually one of these.

Questions about C49.A1

Is C49.A1 a billable ICD-10-CM code?: Yes. C49.A1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does C49.A1 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.A1?: C49.A1 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.A1 (C49) and apply to it just the same.