D48.9
D48.9 — Neoplasm of uncertain behavior, unspecified
Billable / specific codeICD-10-CM
D48.9 is a billable, specific ICD-10-CM code for neoplasm of uncertain behavior, unspecified. It is valid for submission on a claim.
Risk adjustment
D48.9 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
D48.9 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.
- A52479Oral Anticancer Drugs - Policy Article
- A56462Billing and Coding: Erythropoiesis Stimulating Agents (ESA)
- A56505Billing and Coding: Transesophageal Echocardiography (TEE)
- A57452Billing and Coding: Peripheral Nerve Blocks
Related codes at this level
Codes that share D48. If D48.9 is not quite right, the correct code is usually one of these.
- D48.0Neoplasm of uncertain behavior of bone and articular cartilage
- D48.1Neoplasm of uncertain behavior of connective and other soft tissue
- D48.2Neoplasm of uncertain behavior of peripheral nerves and autonomic nervous system
- D48.3Neoplasm of uncertain behavior of retroperitoneum
- D48.4Neoplasm of uncertain behavior of peritoneum
- D48.5Neoplasm of uncertain behavior of skin
- D48.6Neoplasm of uncertain behavior of breast
- D48.7Neoplasm of uncertain behavior of other specified sites
Questions about D48.9
- Is D48.9 a billable ICD-10-CM code?
- Yes. D48.9 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does D48.9 sit in the tabular list?
- Neoplasms (C00-D49), in the block Neoplasms of uncertain behavior, polycythemia vera and myelodysplastic syndromes (D37-D48).