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v1.0.0
ICD-10 Guide
ICD-10 CodesD47.0

D47.0

Billable

Mast cell neoplasms of uncertain behavior

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 D47.0 is a billable code used to indicate a diagnosis of mast cell neoplasms of uncertain behavior.

Key Diagnostic Point:

Mast cell neoplasms of uncertain behavior are a group of hematological disorders characterized by the abnormal proliferation of mast cells, which are a type of white blood cell involved in allergic responses and inflammation. These neoplasms can present in various forms, including localized cutaneous mastocytosis or systemic mastocytosis, and are classified as having uncertain behavior due to their potential for malignant transformation. The clinical presentation can vary widely, with some patients experiencing mild symptoms such as skin lesions, while others may develop more severe manifestations, including anaphylaxis or organ dysfunction. Diagnosis typically involves a combination of clinical evaluation, histopathological examination, and immunohistochemical staining for mast cell markers. Surveillance is crucial, as these neoplasms can progress to more aggressive forms, necessitating ongoing monitoring and management strategies tailored to the individual patient's risk profile. The uncertain behavior classification indicates that while these neoplasms may not currently exhibit malignant characteristics, there is a potential for progression, making careful follow-up essential.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and symptoms
  • Need for histopathological confirmation
  • Potential for progression to malignancy
  • Differentiation from other hematological neoplasms

Audit Risk Factors

  • Inadequate documentation of clinical findings
  • Failure to document follow-up and surveillance plans
  • Misclassification of neoplasm behavior
  • Lack of histopathological evidence in records

Specialty Focus

Medical Specialties

Hematology/Oncology

Documentation Requirements

Detailed clinical notes, histopathology reports, and treatment plans.

Common Clinical Scenarios

Diagnosis and management of mast cell neoplasms, monitoring for progression.

Billing Considerations

Ensure accurate staging and behavior classification in documentation.

Dermatology

Documentation Requirements

Clinical photographs, biopsy results, and treatment responses.

Common Clinical Scenarios

Evaluation of cutaneous mastocytosis and related skin lesions.

Billing Considerations

Documenting the extent of skin involvement and any systemic symptoms.

Coding Guidelines

Inclusion Criteria

Use D47.0 When
  • Follow ICD
  • CM guidelines for neoplasms, ensuring accurate documentation of behavior and any associated symptoms
  • Include relevant history and treatment plans to support the diagnosis

Exclusion Criteria

Do NOT use D47.0 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

88305CPT Code

Pathology consultation

Clinical Scenario

Used when a biopsy is performed to confirm mast cell neoplasm.

Documentation Requirements

Pathology report detailing findings and diagnosis.

Specialty Considerations

Ensure that the pathology report is linked to the clinical diagnosis.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of mast cell neoplasms, improving the accuracy of data collection and reimbursement processes. D47.0 provides a clear classification for neoplasms of uncertain behavior, which was less defined in ICD-9.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of mast cell neoplasms, improving the accuracy of data collection and reimbursement processes. D47.0 provides a clear classification for neoplasms of uncertain behavior, which was less defined in ICD-9.

Reimbursement & Billing Impact

reimbursement processes. D47.0 provides a clear classification for neoplasms of uncertain behavior, which was less defined in ICD-9.

Resources

Clinical References

  • •
    American Society of Hematology
  • •
    National Cancer Institute

Coding & Billing References

  • •
    American Society of Hematology
  • •
    National Cancer Institute

Frequently Asked Questions

What is the significance of coding D47.0?

Coding D47.0 is significant as it indicates the presence of a mast cell neoplasm that requires careful monitoring due to its uncertain behavior. Accurate coding ensures appropriate management and follow-up care.

How often should patients with D47.0 be monitored?

Patients with D47.0 should be monitored regularly, with follow-up visits typically scheduled every 3 to 6 months, depending on clinical findings and risk factors.