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ICD-10 Guide
ICD-10 CodesD48.19

D48.19

Billable

Other specified neoplasm of uncertain behavior of connective and other soft tissue

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

Code Description

ICD-10 D48.19 is a billable code used to indicate a diagnosis of other specified neoplasm of uncertain behavior of connective and other soft tissue.

Key Diagnostic Point:

D48.19 refers to neoplasms of uncertain behavior that arise from connective and other soft tissues, which may include fibromas, lipomas, and other soft tissue tumors that do not fit into more specific categories. These neoplasms are characterized by their ambiguous biological behavior, meaning they may exhibit benign characteristics but have the potential for malignant transformation. The uncertainty surrounding their behavior necessitates careful monitoring and evaluation through imaging studies and histopathological examination. Clinicians often recommend regular follow-ups to assess any changes in size or symptoms, as these neoplasms can sometimes progress to malignancy. The management of these neoplasms may involve surgical intervention, especially if there is a concern for growth or symptomatic presentation. Accurate coding is essential for appropriate treatment planning and resource allocation in healthcare settings.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Ambiguity in behavior classification
  • Need for detailed clinical documentation
  • Variability in tumor presentation
  • Potential for malignant transformation

Audit Risk Factors

  • Insufficient documentation of tumor characteristics
  • Lack of follow-up notes indicating surveillance
  • Inconsistent terminology in pathology reports
  • Failure to document the rationale for coding uncertainty

Specialty Focus

Medical Specialties

Oncology

Documentation Requirements

Detailed pathology reports, imaging studies, and treatment plans.

Common Clinical Scenarios

Management of soft tissue tumors, surveillance of neoplasms, and surgical interventions.

Billing Considerations

Ensure clear documentation of tumor behavior and any changes over time.

Pathology

Documentation Requirements

Comprehensive histopathological reports and diagnostic criteria.

Common Clinical Scenarios

Evaluation of soft tissue biopsies and determination of tumor behavior.

Billing Considerations

Accurate classification of neoplasms based on histological findings.

Coding Guidelines

Inclusion Criteria

Use D48.19 When
  • According to ICD
  • 10 guidelines, D48
  • 19 should be used when the neoplasm's behavior is uncertain and does not fit into more specific categories
  • Coders must ensure that the documentation supports the diagnosis and reflects the uncertainty in behavior

Exclusion Criteria

Do NOT use D48.19 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

88305CPT Code

Pathology examination, surgical

Clinical Scenario

Used when a biopsy of the neoplasm is performed.

Documentation Requirements

Pathology report detailing the findings and diagnosis.

Specialty Considerations

Pathologists must provide clear descriptions of tumor behavior.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of neoplasms, including those of uncertain behavior, which aids in better tracking and management of these conditions.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of neoplasms, including those of uncertain behavior, which aids in better tracking and management of these conditions.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of neoplasms, including those of uncertain behavior, which aids in better tracking and management of these conditions.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What is the significance of coding D48.19?

Coding D48.19 is crucial for accurately representing neoplasms of uncertain behavior, which can impact treatment decisions and healthcare resource allocation.