Is D48.6 a billable ICD-10-CM code?

No. D48.6 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does D48.6 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 D48.6?

D48.6 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 D48.6 (D48) and apply to it just the same.

D48.6

D48.6 — Neoplasm of uncertain behavior of breast

Non-billable headerICD-10-CM

D48.6 is a non-billable header ICD-10-CM code for neoplasm of uncertain behavior of breast. 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 skin of breast (D48.5)

Inclusion terms

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

Neoplasm of uncertain behavior of connective tissue of breast
Cystosarcoma phyllodes

Excludes1 inherited from the categories above D48.6

These are not written on D48.6, but they bind it: a note on a category applies to every code beneath it. Billing D48.6 with anything listed here is a denial.

Written on D48 — Neoplasm of uncertain behavior of other and unspecified sites

neurofibromatosis (nonmalignant) (Q85.0-)

Other codes that can never be billed with D48.6

These codes carry an Excludes1 note pointing at D48.6. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading D48.6 alone.

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

Risk adjustment

D48.6 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.

Code history

D48.6 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Code to one of these instead D48.6

3 child codes. Green means billable.

Related codes at this level

Codes that share D48. If D48.6 is not quite right, the correct code is usually one of these.

Questions about D48.6

Is D48.6 a billable ICD-10-CM code?: No. D48.6 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does D48.6 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 D48.6?: D48.6 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 D48.6 (D48) and apply to it just the same.