Is D37.05 a billable ICD-10-CM code?

Yes. D37.05 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does D37.05 sit in the tabular list?

Neoplasms (C00-D49), in the block Neoplasms of uncertain behavior, polycythemia vera and myelodysplastic syndromes (D37-D48).

What cannot be coded together with D37.05?

D37.05 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 D37.05 (D37.0, D37) and apply to it just the same.

D37.05

D37.05 — Neoplasm of uncertain behavior of pharynx

Billable / specific codeICD-10-CM

D37.05 is a billable, specific ICD-10-CM code for neoplasm of uncertain behavior of pharynx. It is valid for submission on a claim.

Inclusion terms

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

Neoplasm of uncertain behavior of aryepiglottic fold of pharynx NOS
Neoplasm of uncertain behavior of hypopharyngeal aspect of aryepiglottic fold of pharynx
Neoplasm of uncertain behavior of marginal zone of aryepiglottic fold of pharynx

Excludes1 inherited from the categories above D37.05

These are not written on D37.05, but they bind it: a note on a category applies to every code beneath it. Billing D37.05 with anything listed here is a denial.

Written on D37.0 — Neoplasm of uncertain behavior of lip, oral cavity and pharynx

neoplasm of uncertain behavior of aryepiglottic fold or interarytenoid fold, laryngeal aspect (D38.0)
neoplasm of uncertain behavior of epiglottis NOS (D38.0)
neoplasm of uncertain behavior of skin of lip (D48.5)
neoplasm of uncertain behavior of suprahyoid portion of epiglottis (D38.0)

Written on D37 — Neoplasm of uncertain behavior of oral cavity and digestive organs

stromal tumors of uncertain behavior of digestive system (D48.1-)

Other codes that can never be billed with D37.05

These codes carry an Excludes1 note pointing at D37.05. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading D37.05 alone.

D38.0Neoplasm of uncertain behavior of larynx

Risk adjustment

D37.05 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

Medicare coverage

D37.05 is named in 21 Medicare coverage policies — 21 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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Code history

D37.05 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 D37.0. If D37.05 is not quite right, the correct code is usually one of these.

Questions about D37.05

Is D37.05 a billable ICD-10-CM code?: Yes. D37.05 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does D37.05 sit in the tabular list?: Neoplasms (C00-D49), in the block Neoplasms of uncertain behavior, polycythemia vera and myelodysplastic syndromes (D37-D48).
What cannot be coded together with D37.05?: D37.05 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 D37.05 (D37.0, D37) and apply to it just the same.