D49.81
D49.81: Neoplasm of unspecified behavior of retina and choroid
Billable / specific codeICD-10-CM
D49.81 is a billable, specific ICD-10-CM code for neoplasm of unspecified behavior of retina and choroid. It is valid for submission on a claim.
Check D49.81 with the rest of the claim: free scrubberInclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Dark area on retina
- Retinal freckle
Excludes1 inherited from the categories above D49.81
A category’s note binds every code beneath it.
Written on D49.8: Neoplasm of unspecified behavior of other specified sites
Excludes2 inherited from the categories above D49.81
Not part of this code, but both may be coded when both are present.
Other codes that can never be billed with D49.81
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
D49.81 is named in 20 Medicare coverage policies: 20 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A52480Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) - Policy Article
- A53060Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
- A56462Billing and Coding: Erythropoiesis Stimulating Agents (ESA)
- A56464Billing and Coding: Flow Cytometry
Alphabetic index entries that lead here
- Freckle›retinal
- Retina, retinal›dark area
Code history
Unchanged in every release from FY2024 to FY2027.