C49.A3: Gastrointestinal stromal tumor of small intestine
C49.A3 is a billable, specific ICD-10-CM code for gastrointestinal stromal tumor of small intestine. It is valid for submission on a claim.
Check C49.A3 with the rest of the claim: free scrubberExcludes1 inherited from the categories above C49.A3
A category’s note binds every code beneath it.
Excludes2 inherited from the categories above C49.A3
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.A3 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.A3 is named in 53 Medicare coverage policies: 53 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A52479Oral Anticancer Drugs - Policy Article
- A52480Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) - Policy Article
- A52986Billing and Coding: Biomarkers for Oncology
- A54768Billing and Coding: Cardiac Blood Pool Imaging (Multiple Gated Acquisition Scanning- MUGA, Ventriculography) When Performed in Conjunction with Cardiotoxic Chemotherapy
Alphabetic index entries that lead here
- Tumor›stromal›gastrointestinal›small intestine
- Tumor›stromal›gastrointestinal›malignant›duodenum
- Tumor›stromal›gastrointestinal›malignant›ileum
- Tumor›stromal›gastrointestinal›malignant›jejunum
- Tumor›stromal›gastrointestinal›malignant›Meckel diverticulum
- Tumor›stromal›gastrointestinal›malignant›small intestine
- Tumor›stromal›intestine›malignant›small
Code history
Unchanged in every release from FY2024 to FY2027.
Other codes under C49.A
- C49.A0Gastrointestinal stromal tumor, unspecified site
- C49.A1Gastrointestinal stromal tumor of esophagus
- C49.A2Gastrointestinal stromal tumor of stomach
- C49.A4Gastrointestinal stromal tumor of large intestine
- C49.A5Gastrointestinal stromal tumor of rectum
- C49.A9Gastrointestinal stromal tumor of other sites