D49.4
D49.4 — Neoplasm of unspecified behavior of bladder
Billable / specific codeICD-10-CM
D49.4 is a billable, specific ICD-10-CM code for neoplasm of unspecified behavior of bladder. It is valid for submission on a claim.
Risk adjustment
D49.4 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
D49.4 is named in 23 Medicare coverage policies — 23 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A52986Billing and Coding: Biomarkers for Oncology
- A53095Billing and Coding: Lab: Bladder/Urothelial Tumor Markers
- A53101Billing and Coding: MolDX: bioTheranostics Cancer TYPE ID® Update
- A54188Billing and Coding: MolDX: bioTheranostics Cancer TYPE ID®
Related codes at this level
Codes that share D49. If D49.4 is not quite right, the correct code is usually one of these.
- 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
- D49.5Neoplasm 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 D49.4
- Is D49.4 a billable ICD-10-CM code?
- Yes. D49.4 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does D49.4 sit in the tabular list?
- Neoplasms (C00-D49), in the block Neoplasms of unspecified behavior (D49).