ICD-10 Diagnosis Code D49.3

Neoplasm of unspecified behavior of breast

Diagnosis Code D49.3

ICD-10: D49.3
Short Description: Neoplasm of unspecified behavior of breast
Long Description: Neoplasm of unspecified behavior of breast
This is the 2019 version of the ICD-10-CM diagnosis code D49.3

Valid for Submission
The code D49.3 is valid for submission for HIPAA-covered transactions.

Code Classification
  • Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50–D89)
    • Neoplasms of unspecified behavior (D49)
      • Neoplasms of unspecified behavior (D49)


Version 2019 Billable Code Neoplasm Unspecified Behavior

Information for Medical Professionals

Diagnostic Related Groups
The diagnosis code D49.3 is grouped in the following Diagnostic Related Group(s) (MS-DRG V35.0)

  • 597 - MALIGNANT BREAST DISORDERS WITH MCC
  • 598 - MALIGNANT BREAST DISORDERS WITH CC
  • 599 - MALIGNANT BREAST DISORDERS WITHOUT CC/MCC
  • 600 - NON-MALIGNANT BREAST DISORDERS WITH CC/MCC
  • 601 - NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC

Convert to ICD-9
  • 239.3 - Breast neoplasm NOS

Synonyms
  • Neoplasm of areola of female breast
  • Neoplasm of areola of male breast
  • Neoplasm of axillary tail of female breast
  • Neoplasm of breast
  • Neoplasm of central portion of female breast
  • Neoplasm of ectopic female breast tissue
  • Neoplasm of ectopic male breast tissue
  • Neoplasm of female breast
  • Neoplasm of lower inner quadrant of female breast
  • Neoplasm of lower outer quadrant of female breast
  • Neoplasm of male breast
  • Neoplasm of nipple of female breast
  • Neoplasm of nipple of male breast
  • Neoplasm of upper inner quadrant of female breast
  • Neoplasm of upper outer quadrant of female breast
  • Surgical margin involvement by tumor present

Tabular List of Diseases and Injuries
References found for the code D49.3 in the Tabular List of Diseases and Injuries:

  • Type 1 Excludes Notes:
    • neoplasm of unspecified behavior of skin of breast (D49.2)

Table of Neoplasms

The code D49.3 is included in the table of neoplasms by anatomical site. For each site there are six possible code numbers according to whether the neoplasm in question is malignant, benign, in situ, of uncertain behavior, or of unspecified nature. The description of the neoplasm will often indicate which of the six columns is appropriate.

Where such descriptors are not present, the remainder of the Index should be consulted where guidance is given to the appropriate column for each morphological (histological) variety listed. However, the guidance in the Index can be overridden if one of the descriptors mentioned above is present.

The Tabular must be reviewed for the complete diagnosis code.

Neoplasm, neoplastic Malignant
Primary
Malignant
Secondary
CaInSitu Benign Uncertain
Behavior
Unspecified
Behavior
»areola
C50.0C79.81D05.D24.D48.6D49.3
»breast (connective tissue) (glandular tissue) (soft parts)
C50.9C79.81D05.D24.D48.6D49.3
»breast (connective tissue) (glandular tissue) (soft parts)
  »areola
C50.0C79.81D05.D24.D48.6D49.3
»breast (connective tissue) (glandular tissue) (soft parts)
  »axillary tail
C50.6C79.81D05.D24.D48.6D49.3
»breast (connective tissue) (glandular tissue) (soft parts)
  »central portion
C50.1C79.81D05.D24.D48.6D49.3
»breast (connective tissue) (glandular tissue) (soft parts)
  »inner
C50.8C79.81D05.D24.D48.6D49.3
»breast (connective tissue) (glandular tissue) (soft parts)
  »lower
C50.8C79.81D05.D24.D48.6D49.3
»breast (connective tissue) (glandular tissue) (soft parts)
  »lower-inner quadrant
C50.3C79.81D05.D24.D48.6D49.3
»breast (connective tissue) (glandular tissue) (soft parts)
  »lower-outer quadrant
C50.5C79.81D05.D24.D48.6D49.3
»breast (connective tissue) (glandular tissue) (soft parts)
  »midline
C50.8C79.81D05.D24.D48.6D49.3
»breast (connective tissue) (glandular tissue) (soft parts)
  »nipple
C50.0C79.81D05.D24.D48.6D49.3
»breast (connective tissue) (glandular tissue) (soft parts)
  »outer
C50.8C79.81D05.D24.D48.6D49.3
»breast (connective tissue) (glandular tissue) (soft parts)
  »tail (axillary)
C50.6C79.81D05.D24.D48.6D49.3
»breast (connective tissue) (glandular tissue) (soft parts)
  »upper
C50.8C79.81D05.D24.D48.6D49.3
»breast (connective tissue) (glandular tissue) (soft parts)
  »upper-inner quadrant
C50.2C79.81D05.D24.D48.6D49.3
»breast (connective tissue) (glandular tissue) (soft parts)
  »upper-outer quadrant
C50.4C79.81D05.D24.D48.6D49.3

Information for Patients


Breast Diseases

Most women experience breast changes at some time. Your age, hormone levels, and medicines you take may cause lumps, bumps, and discharges (fluids that are not breast milk).

If you have a breast lump, pain, discharge or skin irritation, see your health care provider. Minor and serious breast problems have similar symptoms. Although many women fear cancer, most breast problems are not cancer.

Some common breast changes are

  • Fibrocystic breast changes - lumpiness, thickening and swelling, often just before a woman's period
  • Cysts - fluid-filled lumps
  • Fibroadenomas - solid, round, rubbery lumps that move easily when pushed, occurring most in younger women
  • Intraductal papillomas - growths similar to warts near the nipple
  • Blocked milk ducts
  • Milk production when a woman is not breastfeeding

NIH: National Cancer Institute

  • Breast - premenstrual tenderness and swelling (Medical Encyclopedia)
  • Breast biopsy -- stereotactic (Medical Encyclopedia)
  • Breast biopsy -- ultrasound (Medical Encyclopedia)
  • Breast infection (Medical Encyclopedia)
  • Breast lump (Medical Encyclopedia)
  • Breast MRI scan (Medical Encyclopedia)
  • Breast pain (Medical Encyclopedia)
  • Breast self exam (Medical Encyclopedia)
  • Breast skin and nipple changes (Medical Encyclopedia)
  • Fibroadenoma - breast (Medical Encyclopedia)
  • Fibrocystic breast disease (Medical Encyclopedia)
  • Gynecomastia (Medical Encyclopedia)
  • Intraductal papilloma (Medical Encyclopedia)
  • Nipple problems (Medical Encyclopedia)

[Read More]

ICD-10 Footnotes

General Equivalence Map Definitions
The ICD-10 and ICD-9 GEMs are used to facilitate linking between the diagnosis codes in ICD-9-CM and the new ICD-10-CM code set. The GEMs are the raw material from which providers, health information vendors and payers can derive specific applied mappings to meet their needs.

  • Approximate Flag - The approximate flag is on, indicating that the relationship between the code in the source system and the code in the target system is an approximate equivalent.
  • No Map Flag - The no map flag indicates that a code in the source system is not linked to any code in the target system.
  • Combination Flag - The combination flag indicates that more than one code in the target system is required to satisfy the full equivalent meaning of a code in the source system.

Index of Diseases and Injuries Definitions

  • And - The word "and" should be interpreted to mean either "and" or "or" when it appears in a title.
  • Code also note - A "code also" note instructs that two codes may be required to fully describe a condition, but this note does not provide sequencing direction.
  • Code first - Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. For such conditions, the ICD-10-CM has a coding convention that requires the underlying condition be sequenced first followed by the manifestation. Wherever such a combination exists, there is a "use additional code" note at the etiology code, and a "code first" note at the manifestation code. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation.
  • Type 1 Excludes Notes - 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.
  • Type 2 Excludes Notes - A type 2 Excludes note represents "Not included here". An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.
  • Includes Notes - This note appears immediately under a three character code title to further define, or give examples of, the content of the category.
  • Inclusion terms - List of terms is included under some codes. These terms are the conditions for which that code is to be used. The terms may be synonyms of the code title, or, in the case of "other specified" codes, the terms are a list of the various conditions assigned to that code. The inclusion terms are not necessarily exhaustive. Additional terms found only in the Alphabetic Index may also be assigned to a code.
  • NEC "Not elsewhere classifiable" - This abbreviation in the Alphabetic Index represents "other specified". When a specific code is not available for a condition, the Alphabetic Index directs the coder to the "other specified” code in the Tabular List.
  • NOS "Not otherwise specified" - This abbreviation is the equivalent of unspecified.
  • See - The "see" instruction following a main term in the Alphabetic Index indicates that another term should be referenced. It is necessary to go to the main term referenced with the "see" note to locate the correct code.
  • See Also - A "see also" instruction following a main term in the Alphabetic Index instructs that there is another main term that may also be referenced that may provide additional Alphabetic Index entries that may be useful. It is not necessary to follow the "see also" note when the original main term provides the necessary code.
  • 7th Characters - Certain ICD-10-CM categories have applicable 7th characters. The applicable 7th character is required for all codes within the category, or as the notes in the Tabular List instruct. The 7th character must always be the 7th character in the data field. If a code that requires a 7th character is not 6 characters, a placeholder X must be used to fill in the empty characters.
  • With - The word "with" should be interpreted to mean "associated with" or "due to" when it appears in a code title, the Alphabetic Index, or an instructional note in the Tabular List. The word "with" in the Alphabetic Index is sequenced immediately following the main term, not in alphabetical order.

Present on Admission
The Present on Admission (POA) indicator is used for diagnosis codes included in claims involving inpatient admissions to general acute care hospitals. POA indicators must be reported to CMS on each claim to facilitate the grouping of diagnoses codes into the proper Diagnostic Related Groups (DRG). CMS publishes a listing of specific diagnosis codes that are exempt from the POA reporting requirement.

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