Is ICD-10-CM code D38 billable?

No, D38 (Neoplasm of uncertain behavior of middle ear and respiratory and intrathoracic organs) is a non-billable ICD-10-CM code. It must be coded to a more specific subcategory before it can be used for reimbursement.

What chapter does ICD-10-CM code D38 belong to?

D38 belongs to Chapter 2 of the ICD-10-CM tabular list: C00–D49 (Neoplasms).

D38Not billable, use a more specific code below

Neoplasm of uncertain behavior of middle ear and respiratory and intrathoracic organs

In Neoplasms of uncertain behavior, polycythemia vera and myelodysplastic syndromes (D37-D48), chapter 2: Neoplasms

7 billable codes under D38: none are a CC or MCC; none map to an HCC.

Instructional notes

Excludes1: not coded here, use a different code

neoplasm of uncertain behavior of heart (D48.7)

Also applies, from Neoplasms of uncertain behavior, polycythemia vera and myelodysplastic syndromes (D37-D48)

These notes sit on D37-D48 and apply to every code under it, including D38.

Excludes1: not coded here, use a different code

neoplasms of unspecified behavior (D49.-)

Official coding guidelines

From the ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027 (CMS and NCHS). Links open the PDF at the right page.

Rules for coding benign and malignant neoplasms: using the Neoplasm Table, sequencing primary and secondary sites, treatment encounters, complications, and current cancer versus personal history.

Admission/Encounter for treatment of primary site (page 33)
Admission/Encounter for treatment of secondary site (page 33)
Coding and sequencing of complications (page 34)
Primary malignancy previously excised (page 34)
Admissions/Encounters involving antineoplastic chemotherapy, immunotherapy and radiation therapy (page 35)
Admission/encounter to determine extent of malignancy (page 36)
Symptoms, signs, and abnormal findings listed in Chapter 18 associated with neoplasms (page 36)
Admission/encounter for pain control/management (page 36)

Read Section I.C.2 (page 32), 12 more topics

All codes under D38

D38 can't be used on a claim. Pick a billable code below; grey headings group them.

D38 MS-DRGs

As the principal diagnosis, the billable codes under D38 group to MS-DRG 180, 181, or 182 (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.

DRG 180 Respiratory Neoplasms with MCC (6 of 7 codes)
DRG 181 Respiratory Neoplasms with CC (6 of 7 codes)
DRG 182 Respiratory Neoplasms without CC/MCC (6 of 7 codes)

About the condition

Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.

Ear Disorders

An ear disorder is any condition that changes or harms the shape or structure of your ear. This can include abnormal ear shapes you're born with, injuries that change your ear's shape, and a growth on or in the ear.

Lung Diseases

When you breathe, your lungs take in oxygen from the air and deliver it to the bloodstream. The cells in your body need oxygen to work and grow. During a normal day, you breathe nearly 25,000 times. People with lung disease have difficulty breathing. Millions of people in the U.S. have lung disease. If all types of lung disease are lumped together, it is the number three killer in the United States.

Code history

Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.