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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ICD-10-CM Code For Neoplasms Of Unspecified Behavior: Group Overview

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

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 Code	Description
D49.0	Neoplasm of unspecified behavior of digestive system
D49.1	Neoplasm of unspecified behavior of respiratory system
D49.2	Neoplasm of unspecified behavior of bone, soft tissue, and skin
D49.3	Neoplasm of unspecified behavior of breast
D49.4	Neoplasm of unspecified behavior of bladder
D49.511	Neoplasm of unspecified behavior of right kidney
D49.512	Neoplasm of unspecified behavior of left kidney
D49.519	Neoplasm of unspecified behavior of unspecified kidney
D49.59	Neoplasm of unspecified behavior of other genitourinary organ
D49.6	Neoplasm of unspecified behavior of brain
D49.7	Neoplasm of unspecified behavior of endocrine glands and other parts of nervous system
D49.81	Neoplasm of unspecified behavior of retina and choroid
D49.89	Neoplasm of unspecified behavior of other specified sites
D49.9	Neoplasm of unspecified behavior of unspecified site

DRG Codes

33 rows

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

ICD-10-CM Codes

14 rows

ICD-10-CM Code	Description
D49.0	Neoplasm of unspecified behavior of digestive system
D49.1	Neoplasm of unspecified behavior of respiratory system
D49.2	Neoplasm of unspecified behavior of bone, soft tissue, and skin
D49.3	Neoplasm of unspecified behavior of breast
D49.4	Neoplasm of unspecified behavior of bladder
D49.511	Neoplasm of unspecified behavior of right kidney
D49.512	Neoplasm of unspecified behavior of left kidney
D49.519	Neoplasm of unspecified behavior of unspecified kidney
D49.59	Neoplasm of unspecified behavior of other genitourinary organ
D49.6	Neoplasm of unspecified behavior of brain
D49.7	Neoplasm of unspecified behavior of endocrine glands and other parts of nervous system
D49.81	Neoplasm of unspecified behavior of retina and choroid
D49.89	Neoplasm of unspecified behavior of other specified sites
D49.9	Neoplasm of unspecified behavior of unspecified site

DRG Codes

33 rows

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

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

ICD-10-CM Code For Neoplasms Of Unspecified Behavior: Group Overview

Sign up for ICD-10-CM Code For Neoplasms Of Unspecified Behavior: Group Overview policy alerts

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

ICD-10-CM Code For Neoplasms Of Unspecified Behavior: Group Overview

Sign up for ICD-10-CM Code For Neoplasms Of Unspecified Behavior: Group Overview policy alerts

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

When to Use

ICD-10-CM Codes

DRG Codes

Typical Clinical Scenarios

When should I use `D49` group codes?

Which specific codes in the `D49` group indicate kidney involvement?

How do `D49` codes relate to DRG assignment?

What sites are covered by `D49.0` through `D49.9` series?

Why is accurate documentation important when using `D49` codes?

References

When to Use

ICD-10-CM Codes

DRG Codes

Typical Clinical Scenarios

When should I use `D49` group codes?

Which specific codes in the `D49` group indicate kidney involvement?

How do `D49` codes relate to DRG assignment?

What sites are covered by `D49.0` through `D49.9` series?

Why is accurate documentation important when using `D49` codes?

References