D49.59 — Neoplasm of unspecified behavior of other genitourinary organ
D49.59 is a billable, specific ICD-10-CM code for neoplasm of unspecified behavior of other genitourinary organ. It is valid for submission on a claim.
Other codes that can never be billed with D49.59
These codes carry an Excludes1 note pointing at D49.59. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading D49.59 alone.
- D49.2Neoplasm of unspecified behavior of bone, soft tissue, and skin
Risk adjustment
D49.59 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
D49.59 is named in 32 Medicare coverage policies — 32 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
- A52479Oral Anticancer Drugs - Policy Article
- A52479Oral Anticancer Drugs - Policy Article
- A52479Oral Anticancer Drugs - Policy Article
Related codes at this level
Codes that share D49.5. If D49.59 is not quite right, the correct code is usually one of these.
Questions about D49.59
- Is D49.59 a billable ICD-10-CM code?
- Yes. D49.59 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does D49.59 sit in the tabular list?
- Neoplasms (C00-D49), in the block Neoplasms of unspecified behavior (D49).