Is D48.1 a billable ICD-10-CM code?

No. D48.1 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does D48.1 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 D48.1?

D48.1 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

D48.1

D48.1 — Neoplasm of uncertain behavior of connective and other soft tissue

Non-billable headerICD-10-CM

D48.1 is a non-billable header ICD-10-CM code for neoplasm of uncertain behavior of connective and other soft tissue. It cannot be billed on its own: choose one of the more specific child codes below.

Excludes1 — never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

neoplasm of uncertain behavior of articular cartilage (D48.0)
neoplasm of uncertain behavior of cartilage of larynx (D38.0)
neoplasm of uncertain behavior of cartilage of nose (D38.5)
neoplasm of uncertain behavior of connective tissue of breast (D48.6-)

Inclusion terms

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

Neoplasm of uncertain behavior of connective tissue of ear
Neoplasm of uncertain behavior of connective tissue of eyelid
Stromal tumors of uncertain behavior of digestive system

Other codes that can never be billed with D48.1

These codes carry an Excludes1 note pointing at D48.1. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading D48.1 alone.

D37Neoplasm of uncertain behavior of oral cavity and digestive organs
D48.0Neoplasm of uncertain behavior of bone and articular cartilage
D48.7Neoplasm of uncertain behavior of other specified sites

Risk adjustment

D48.1 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.

Code to one of these instead D48.1

2 child codes. Green means billable.

Related codes at this level

Codes that share D48. If D48.1 is not quite right, the correct code is usually one of these.

Questions about D48.1

Is D48.1 a billable ICD-10-CM code?: No. D48.1 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does D48.1 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 D48.1?: D48.1 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.