D49.0

D49.0: Neoplasm of unspecified behavior of digestive system

Billable / specific codeICD-10-CM

D49.0 is a billable, specific ICD-10-CM code for neoplasm of unspecified behavior of digestive system. It is valid for submission on a claim.

Check D49.0 with the rest of the claim: free scrubber

Excludes1: never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

neoplasm of unspecified behavior of margin of anus (D49.2)
neoplasm of unspecified behavior of perianal skin (D49.2)
neoplasm of unspecified behavior of skin of anus (D49.2)

Excludes2 inherited from the categories above D49.0

Not part of this code, but both may be coded when both are present.

Written on D49: Neoplasms of unspecified behavior

neoplasms of uncertain behavior (D37-D44, D48)

Other codes that can never be billed with D49.0

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

Risk adjustment

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

Medicare coverage

D49.0 is named in 26 Medicare coverage policies: 26 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

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Code history

Unchanged in every release from FY2024 to FY2027.