D49Not billable, use a more specific code below
Neoplasms of unspecified behavior
chapter 2: Neoplasms
14 billable codes under D49: none are a CC or MCC; 1 map to HCC 23 (Prostate, Breast, and Other Cancers and Tumors).An HCC counts toward a Medicare Advantage patient's risk score.
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Instructional notes
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)
All codes under D49
D49 can't be used on a claim. Pick a billable code below; grey headings group them.
- 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
- D49.4Neoplasm of unspecified behavior of bladder
- D49.5Neoplasm of unspecified behavior of other genitourinary organs
- D49.51Neoplasm of unspecified behavior of kidney
- D49.511Neoplasm of unspecified behavior of right kidney
- D49.512Neoplasm of unspecified behavior of left kidney
- D49.519Neoplasm of unspecified behavior of unspecified kidney
- D49.59Neoplasm of unspecified behavior of other genitourinary organ
- 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
- D49.81Neoplasm of unspecified behavior of retina and choroid
- D49.89Neoplasm of unspecified behavior of other specified sites
- D49.9Neoplasm of unspecified behavior of unspecified site
D49 MS-DRGs
As the principal diagnosis, the billable codes under D49 group to these 30 MS-DRGs (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.
- DRG 656 Kidney and Ureter Procedures for Neoplasm with MCC (5 of 14 codes)
- DRG 657 Kidney and Ureter Procedures for Neoplasm with CC (5 of 14 codes)
- DRG 658 Kidney and Ureter Procedures for Neoplasm without CC/MCC (5 of 14 codes)
- DRG 686 Kidney and Urinary Tract Neoplasms with MCC (5 of 14 codes)
- DRG 687 Kidney and Urinary Tract Neoplasms with CC (5 of 14 codes)
- DRG 688 Kidney and Urinary Tract Neoplasms without CC/MCC (5 of 14 codes)
- DRG 826 Myeloproliferative Disorders or Poorly Differentiated Neoplasms with Major O.R. Procedures with MCC (3 of 14 codes)
- DRG 827 Myeloproliferative Disorders or Poorly Differentiated Neoplasms with Major O.R. Procedures with CC (3 of 14 codes)
- DRG 828 Myeloproliferative Disorders or Poorly Differentiated Neoplasms with Major O.R. Procedures without CC/MCC (3 of 14 codes)
- DRG 829 Myeloproliferative Disorders or Poorly Differentiated Neoplasms with Other Procedures with CC/MCC (3 of 14 codes)
- DRG 830 Myeloproliferative Disorders or Poorly Differentiated Neoplasms with Other Procedures without CC/MCC (3 of 14 codes)
- DRG 843 Other Myeloproliferative Disorders or Poorly Differentiated Neoplastic Diagnoses with MCC (3 of 14 codes)
- DRG 844 Other Myeloproliferative Disorders or Poorly Differentiated Neoplastic Diagnoses with CC (3 of 14 codes)
- DRG 845 Other Myeloproliferative Disorders or Poorly Differentiated Neoplastic Diagnoses without CC/MCC (3 of 14 codes)
- DRG 054 Nervous System Neoplasms with MCC (1 of 14 codes)
- DRG 055 Nervous System Neoplasms without MCC (1 of 14 codes)
- DRG 180 Respiratory Neoplasms with MCC (1 of 14 codes)
- DRG 181 Respiratory Neoplasms with CC (1 of 14 codes)
- DRG 182 Respiratory Neoplasms without CC/MCC (1 of 14 codes)
- DRG 374 Digestive Malignancy with MCC (1 of 14 codes)
- DRG 375 Digestive Malignancy with CC (1 of 14 codes)
- DRG 376 Digestive Malignancy without CC/MCC (1 of 14 codes)
- DRG 456 Spinal Fusion Except Cervical with Spinal Curvature, Malignancy, or Infection with MCC (1 of 14 codes)
- DRG 457 Spinal Fusion Except Cervical with Spinal Curvature, Malignancy, or Infection with CC (1 of 14 codes)
- DRG 458 Spinal Fusion Except Cervical with Spinal Curvature, Malignancy, or Infection without CC/MCC (1 of 14 codes)
- DRG 564 Other Musculoskeletal System and Connective Tissue Diagnoses with MCC (1 of 14 codes)
- DRG 565 Other Musculoskeletal System and Connective Tissue Diagnoses with CC (1 of 14 codes)
- DRG 566 Other Musculoskeletal System and Connective Tissue Diagnoses without CC/MCC (1 of 14 codes)
- DRG 600 Non-Malignant Breast Disorders with CC/MCC (1 of 14 codes)
- DRG 601 Non-Malignant Breast Disorders without CC/MCC (1 of 14 codes)
Other codes that refer to D49
Notes on these codes point to D49.
- CH10 Excludes2: neoplasms (C00-D49)
- CH11 Excludes2: neoplasms (C00-D49)
- CH12 Excludes2: neoplasms (C00-D49)
- CH13 Excludes2: neoplasms (C00-D49)
- CH14 Excludes2: neoplasms (C00-D49)
- CH16 Excludes2: neoplasms (C00-D49)
- CH3 Excludes2: neoplasms (C00-D49)
- CH6 Excludes2: neoplasms (C00-D49)
- CH7 Excludes2: neoplasms (C00-D49)
- CH8 Excludes2: neoplasms (C00-D49)
- CH9 Excludes2: neoplasms (C00-D49)
- D37-D48 Excludes1: neoplasms of unspecified behavior (D49.-)
- D63.0 Code First: neoplasm (C00-D49)
- G13.0 Code First: underlying neoplasm (C00-D49)
- G13.1 Code First: underlying neoplasm (C00-D49)
- G32.8 Code First: cerebral degeneration (due to) neoplasm (C00-D49)
- G32.81 Code First: cerebellar ataxia (in) neoplastic disease (paraneoplastic cerebellar degeneration) (C00-D49)
- G53 Code First: neoplasm (C00-D49)
- G55 Code First: neoplasm (C00-D49)
- G63 Code First: neoplasm (C00-D49)
Code history
Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.