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.
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
These codes carry an Excludes1 note pointing at D49. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading D49 alone.
- C69.2Malignant neoplasm of retina
- D49.3Neoplasm of unspecified behavior of breast
- D31.2Benign neoplasm of retina
- D49.0Neoplasm of unspecified behavior of digestive system
- D49.2Neoplasm of unspecified behavior of bone, soft tissue, and skin
- 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
Risk adjustment
D49 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 to one of these instead D49
10 child codes. Green means billable.
- D49.0Neoplasm of unspecified behavior of digestive system
- D49.1Neoplasm of unspecified behavior of respiratory system
- D49.2Neoplasm of unspecified behavior of bone, soft tissue, and skin
- D49.3Neoplasm of unspecified behavior of breast
- D49.4Neoplasm of unspecified behavior of bladder
- D49.5Neoplasm of unspecified behavior of other genitourinary organs
- 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
- D49.9Neoplasm of unspecified behavior of unspecified site
Questions about D49
- Is D49 a billable ICD-10-CM code?
- No. D49 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does D49 sit in the tabular list?
- Neoplasms (C00-D49), in the block Neoplasms of unspecified behavior (D49).