D48.9 — Neoplasm of uncertain behavior, unspecified
D48.9 is a billable, specific ICD-10-CM code for neoplasm of uncertain behavior, unspecified. It is valid for submission on a claim.
Excludes1 inherited from the categories above D48.9
These are not written on D48.9, but they bind it: a note on a category applies to every code beneath it. Billing D48.9 with anything listed here is a denial.
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
Code history
D48.9 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 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).
- What cannot be coded together with D48.9?
- D48.9 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 D48.9 (D48) and apply to it just the same.