Is D49.6 a billable ICD-10-CM code?

Yes. D49.6 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does D49.6 sit in the tabular list?

Neoplasms (C00-D49), in the block Neoplasms of unspecified behavior (D49).

What cannot be coded together with D49.6?

D49.6 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

D49.6

D49.6 — Neoplasm of unspecified behavior of brain

Billable / specific codeICD-10-CM

D49.6 is a billable, specific ICD-10-CM code for neoplasm of unspecified behavior of brain. It is valid for submission on a claim.

Excludes1 — never code together

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

neoplasm of unspecified behavior of cerebral meninges (D49.7)
neoplasm of unspecified behavior of cranial nerves (D49.7)

Risk adjustment

D49.6 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:

HCC 23 Prostate, Breast, and Other Cancers and Tumors0.186 RAF

Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.

Medicare coverage

D49.6 is named in 30 Medicare coverage policies — 30 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A52450Billing and Coding: Paclitaxel (e.g., Taxol®/Abraxane ™)
A52986Billing and Coding: Biomarkers for Oncology
A53101Billing and Coding: MolDX: bioTheranostics Cancer TYPE ID® Update
A54188Billing and Coding: MolDX: bioTheranostics Cancer TYPE ID®

How D49.6 is indexed

Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to D49.6.

Degeneration, degenerative›brain›in›neoplastic disease

Related codes at this level

Codes that share D49. If D49.6 is not quite right, the correct code is usually one of these.

Questions about D49.6

Is D49.6 a billable ICD-10-CM code?: Yes. D49.6 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does D49.6 sit in the tabular list?: Neoplasms (C00-D49), in the block Neoplasms of unspecified behavior (D49).
What cannot be coded together with D49.6?: D49.6 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.