D49

D49: Neoplasms of unspecified behavior

Non-billable headerICD-10-CM

D49 is a non-billable header ICD-10-CM code for neoplasms of unspecified behavior. It cannot be billed on its own: choose one of the more specific child codes below.

Excludes2: not included here, but may coexist

The excluded condition is not part of this code, but a patient can have both. You may code both.

neoplasms of uncertain behavior (D37-D44, D48)

Includes

Conditions this code covers.

'growth' NOS
neoplasm NOS
new growth NOS
tumor NOS

Notes

Additional guidance from the ICD-10-CM tabular list.

Category D49 classifies by site neoplasms of unspecified morphology and behavior. The term 'mass', unless otherwise stated, is not to be regarded as a neoplastic growth.

Other codes that can never be billed with D49

Their own Excludes1 notes name this code, so the conflict is not listed above.

D49.2Neoplasm of unspecified behavior of bone, soft tissue, and skin
D49.3Neoplasm of unspecified behavior of breast
D49.6Neoplasm of unspecified behavior of brain
D49.7Neoplasm of unspecified behavior of endocrine glands and other parts of nervous system
D49.8Neoplasm of unspecified behavior of other specified sites
D49.0Neoplasm of unspecified behavior of digestive system
C69.2Malignant neoplasm of retina
D31.2Benign neoplasm of retina

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Code history

Unchanged in every release from FY2024 to FY2027.

Code to one of these instead D49

10 child codes. Green means billable.