Is D38.6 a billable ICD-10-CM code?

Yes. D38.6 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does D38.6 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 D38.6?

D38.6 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 D38.6 (D38) and apply to it just the same.

D38.6

D38.6 — Neoplasm of uncertain behavior of respiratory organ, unspecified

Billable / specific codeICD-10-CM

D38.6 is a billable, specific ICD-10-CM code for neoplasm of uncertain behavior of respiratory organ, unspecified. It is valid for submission on a claim.

Excludes1 inherited from the categories above D38.6

These are not written on D38.6, but they bind it: a note on a category applies to every code beneath it. Billing D38.6 with anything listed here is a denial.

Written on D38 — Neoplasm of uncertain behavior of middle ear and respiratory and intrathoracic organs

neoplasm of uncertain behavior of heart (D48.7)

Risk adjustment

D38.6 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

D38.6 is named in 8 Medicare coverage policies — 8 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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A55717Billing and Coding: Lab: Flow Cytometry
A57452Billing and Coding: Peripheral Nerve Blocks

Code history

D38.6 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 D38. If D38.6 is not quite right, the correct code is usually one of these.

Questions about D38.6

Is D38.6 a billable ICD-10-CM code?: Yes. D38.6 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does D38.6 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 D38.6?: D38.6 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 D38.6 (D38) and apply to it just the same.