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    v1.0.28
    OpenPayerBilling CodesNeoplasms of unspecified behaviorICD-10-CM d49-neoplasms-of-unspecified-behavior
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    ICD-10-CM Code For Neoplasms Of Unspecified Behavior: Group Overview

    The International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) code group D49 includes neoplasms of unspecified behavior, covering tumors documented without clear designation as benign, malignant, or in situ and applicable to multiple anatomical sites. These ICD-10-CM diagnosis codes are used to document clinical encounters when tumor behavior is not specified, capturing uncertainty in diagnosis, site involvement, and diagnostic complexity. Accurate coding within the ICD-10-CM D49 group supports proper claim adjudication.

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    ICD-10-CM D49: Neoplasms Of Unspecified Behavior Overview

    The ICD-10-CM D49 group includes neoplasms whose behavior (benign, malignant, or in situ) is not specified in the record; these codes identify tumors where documentation does not state a definitive behavior. These diagnoses can affect multiple organ systems depending on tumor location. Accurate coding matters for correct claim adjudication and reflecting clinical complexity for reimbursement.

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    When to Use

    Use a code from this group when the medical documentation identifies a neoplasm but does not specify whether it is benign, malignant, or in situ. These codes should be selected when the clinician record lacks definitive pathology or behavior classification at the time of coding.

    ICD-10-CM Codes

    14 rows

    ICD-10-CM CodeDescription
    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
    D49.511Neoplasm 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
    D49.81Neoplasm of unspecified behavior of retina and choroid
    D49.89Neoplasm of unspecified behavior of other specified sites
    D49.9Neoplasm of unspecified behavior of unspecified site

    DRG Codes

    33 rows

    DRG CodeDescription
    054Nervous System Neoplasms with MCC
    055Nervous System Neoplasms without MCC
    180Respiratory Neoplasms with MCC
    181Respiratory Neoplasms with CC
    182Respiratory Neoplasms without CC/MCC
    374Digestive Malignancy with MCC
    375Digestive Malignancy with CC
    376Digestive Malignancy without CC/MCC
    456Spinal Fusion Except Cervical with Spinal Curvature, Malignancy, Infection or Extensive Fusions with MCC
    457Spinal Fusion Except Cervical with Spinal Curvature, Malignancy, Infection or Extensive Fusions with CC
    458Spinal Fusion Except Cervical with Spinal Curvature, Malignancy, Infection or Extensive Fusions without CC/MCC
    564Other Musculoskeletal System and Connective Tissue Diagnoses with MCC
    565Other Musculoskeletal System and Connective Tissue Diagnoses with CC
    566Other Musculoskeletal System and Connective Tissue Diagnoses without CC/MCC
    600Non-Malignant Breast Disorders with CC/MCC
    601Non-Malignant Breast Disorders without CC/MCC
    643Endocrine Disorders with MCC
    644Endocrine Disorders with CC
    645Endocrine Disorders without CC/MCC
    656Kidney and Ureter Procedures for Neoplasm with MCC

    Showing 1–20 of 33

    Typical Clinical Scenarios

    • An older adult is evaluated in outpatient oncology clinic after imaging (CT or MRI) identifies a mass in the lung that cannot be definitively characterized on noninvasive studies and biopsy samples are nondiagnostic or not feasible; the clinician documents a neoplasm of uncertain behavior pending further histopathology or follow-up. This situation is chronic/diagnostic uncertainty management rather than an acute presentation, and a code for an unspecified-behavior neoplasm of the respiratory system or thorax is assigned. Typical codes: D49.3.
    • A middle-aged patient presents to the emergency department with acute gastrointestinal bleeding; endoscopy reveals a polypoid lesion in the colon that appears suspicious but frozen section and pathology are inconclusive during the admission, so the working diagnosis is a neoplasm of uncertain behavior of the digestive system. The code is used to capture the lesion as the cause of the acute presentation while definitive malignant vs benign classification is pending. Typical codes: D49.4, D49.2.
    • A young adult with a history of a previously resected skin lesion returns for evaluation of a new subcutaneous nodule at the scar site; dermatology documents a cutaneous/soft tissue neoplasm of uncertain behavior when histology is indeterminate on initial biopsy, and the lesion is managed as an ongoing comorbidity requiring surveillance and possible re-excision. This chronic follow-up and management of an indeterminate lesion is coded to the skin and subcutaneous tissue neoplasm of uncertain behavior category. Typical codes: D49.59, D49.7.

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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