Not Valid for Submission
D49 is a non-specific and non-billable diagnosis code code, consider using a code with a higher level of specificity for a diagnosis of neoplasms of unspecified behavior. The code is not specific and is NOT valid for the year 2022 for the submission of HIPAA-covered transactions. Category or Header define the heading of a category of codes that may be further subdivided by the use of 4th, 5th, 6th or 7th characters.
Unspecified diagnosis codes like D49 are acceptable when clinical information is unknown or not available about a particular condition. Although a more specific code is preferable, unspecified codes should be used when such codes most accurately reflect what is known about a patient's condition. Specific diagnosis codes should not be used if not supported by the patient's medical record.
Specific Coding for Neoplasms of unspecified behavior
Non-specific codes like D49 require more digits to indicate the appropriate level of specificity. Consider using any of the following ICD-10 codes with a higher level of specificity when coding for neoplasms of unspecified behavior:
Tabular List of Diseases and Injuries
The Tabular List of Diseases and Injuries is a list of ICD-10 codes, organized "head to toe" into chapters and sections with coding notes and guidance for inclusions, exclusions, descriptions and more. The following references are applicable to the code D49:
This note appears immediately under a three character code title to further define, or give examples of, the content of the category.
- 'growth' NOS
- neoplasm NOS
- new growth NOS
- tumor NOS
Type 1 ExcludesType 1 Excludes
A type 1 excludes note is a pure excludes note. It means "NOT CODED HERE!" An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
- Category D49 classifies by site neoplasms of unspecified morphology and behavior. The term 'mass', unless otherwise stated, is not to be regarded as a neoplastic growth.