Is D48.61 a billable ICD-10-CM code?

Yes. D48.61 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does D48.61 sit in the tabular list?

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

D48.61

D48.61 — Neoplasm of uncertain behavior of right breast

Billable / specific codeICD-10-CMright

D48.61 is a billable, specific ICD-10-CM code for neoplasm of uncertain behavior of right breast. It is valid for submission on a claim.

Risk adjustment

D48.61 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

D48.61 is named in 26 Medicare coverage policies — 26 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A52480Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) - Policy Article
A52849Billing and Coding: Breast Imaging: Breast Echography (Sonography)/Breast MRI/Ductography
A53101Billing and Coding: MolDX: bioTheranostics Cancer TYPE ID® Update
A54188Billing and Coding: MolDX: bioTheranostics Cancer TYPE ID®

Related codes at this level

Codes that share D48.6. If D48.61 is not quite right, the correct code is usually one of these.

Questions about D48.61

Is D48.61 a billable ICD-10-CM code?: Yes. D48.61 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does D48.61 sit in the tabular list?: Neoplasms (C00-D49), in the block Neoplasms of uncertain behavior, polycythemia vera and myelodysplastic syndromes (D37-D48).