ICD-10 Logo
ICDxICD-10 Medical Coding
ICD-10 Logo
ICDxICD-10 Medical Coding
ICD 10 CodesDiagnoses
ICD 10 CodesDiagnoses
ICD-10 Logo
ICDxICD-10 Medical Coding

Comprehensive ICD-10-CM code reference with AI-powered search capabilities.

© 2025 ICD Code Compass. All rights reserved.

Browse

  • All Chapters
  • All Categories
  • Diagnoses

Tools

  • AI Code Search
ICD-10-CM codes are maintained by the CDC and CMS. This tool is for reference purposes only.
v1.0.0
ICD-10 Guide
ICD-10 CodesD48.7

D48.7

Billable

Neoplasm of uncertain behavior of other specified sites

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

Code Description

ICD-10 D48.7 is a billable code used to indicate a diagnosis of neoplasm of uncertain behavior of other specified sites.

Key Diagnostic Point:

D48.7 refers to neoplasms that are classified as having uncertain behavior, which means that their potential for malignancy is not clearly defined. These neoplasms can arise in various tissues and organs, and their behavior may range from benign to malignant. The uncertainty in behavior often necessitates careful monitoring and follow-up, as the neoplasm may exhibit changes over time that could indicate a progression towards malignancy. Clinicians typically recommend regular imaging studies and biopsies to assess any changes in size, shape, or cellular characteristics. The management of these neoplasms often involves a multidisciplinary approach, including oncologists, pathologists, and radiologists, to ensure appropriate surveillance and intervention when necessary. Accurate coding of D48.7 is crucial for proper patient management and resource allocation, as it reflects the need for ongoing evaluation and potential treatment options.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in documentation of neoplasm behavior
  • Need for precise localization of the neoplasm
  • Differentiation from benign and malignant neoplasms
  • Potential for progression requiring ongoing surveillance

Audit Risk Factors

  • Inadequate documentation of neoplasm behavior
  • Failure to document follow-up plans
  • Misclassification of neoplasm type
  • Lack of imaging or biopsy results in the medical record

Specialty Focus

Medical Specialties

Oncology

Documentation Requirements

Detailed pathology reports, imaging studies, and treatment plans.

Common Clinical Scenarios

Monitoring of a patient with a previously diagnosed neoplasm of uncertain behavior.

Billing Considerations

Ensure that all follow-up visits and imaging results are documented to support the need for ongoing surveillance.

Pathology

Documentation Requirements

Comprehensive histopathological reports and descriptions of cellular characteristics.

Common Clinical Scenarios

Evaluation of biopsy specimens from neoplasms with uncertain behavior.

Billing Considerations

Clear communication of findings that indicate uncertainty in behavior is essential for accurate coding.

Coding Guidelines

Inclusion Criteria

Use D48.7 When
  • According to ICD
  • 10 guidelines, D48
  • 7 should be used when the neoplasm is not classified as benign or malignant and is located in a specified site
  • Coders must ensure that the documentation supports the diagnosis of uncertain behavior and that the site of the neoplasm is clearly identified

Exclusion Criteria

Do NOT use D48.7 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

88305CPT Code

Pathology examination, surgical

Clinical Scenario

Used when a biopsy is performed on a neoplasm of uncertain behavior.

Documentation Requirements

Pathology report must clearly indicate the findings and behavior of the neoplasm.

Specialty Considerations

Pathologists should ensure that the report includes detailed descriptions of cellular characteristics.

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. This specificity aids in better tracking and management of these conditions, improving patient care and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of neoplasms, including those of uncertain behavior. This specificity aids in better tracking and management of these conditions, improving patient care and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of neoplasms, including those of uncertain behavior. This specificity aids in better tracking and management of these conditions, improving patient care and resource allocation.

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 does 'uncertain behavior' mean in the context of neoplasms?

Uncertain behavior indicates that the neoplasm does not clearly fit into benign or malignant categories, necessitating careful monitoring and evaluation.