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v1.0.0
ICD-10 Guide
ICD-10 CodesChapter 2: NeoplasmsD47

D47

Billable

Other neoplasms of uncertain behavior of lymphoid, hematopoietic and related tissue

Chapter 2:Neoplasms

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

Code Description

ICD-10 D47 is a billable code used to indicate a diagnosis of other neoplasms of uncertain behavior of lymphoid, hematopoietic and related tissue.

Key Diagnostic Point:

D47 encompasses a variety of neoplasms that arise from lymphoid, hematopoietic, and related tissues, characterized by their uncertain behavior. These neoplasms may not fit neatly into benign or malignant categories, leading to challenges in management and surveillance. Common examples include certain types of lymphoproliferative disorders and atypical lymphoid hyperplasia. The behavior of these neoplasms can vary significantly, with some having a potential for progression to malignancy, while others may remain stable or regress. Clinicians often rely on histopathological evaluation and clinical follow-up to monitor these conditions. Surveillance strategies may include regular imaging, laboratory tests, and clinical assessments to detect any signs of transformation or progression. Accurate coding is essential for appropriate management and reimbursement, as these neoplasms require careful monitoring and may necessitate specific treatment protocols.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and behavior of neoplasms
  • Need for precise documentation of histopathological findings
  • Differentiation from other neoplasms with similar presentations
  • Potential for progression to malignancy requiring ongoing surveillance

Audit Risk Factors

  • Inadequate documentation of clinical findings
  • Failure to specify the type of neoplasm
  • Misclassification of neoplasm behavior
  • Lack of follow-up documentation indicating surveillance

Specialty Focus

Medical Specialties

Hematology/Oncology

Documentation Requirements

Detailed pathology reports, treatment plans, and follow-up notes.

Common Clinical Scenarios

Diagnosis and management of lymphoproliferative disorders, monitoring for progression.

Billing Considerations

Ensure accurate staging and classification of neoplasms based on histological findings.

Pathology

Documentation Requirements

Comprehensive histopathological reports with clear descriptions of findings.

Common Clinical Scenarios

Evaluation of biopsy specimens for uncertain behavior neoplasms.

Billing Considerations

Pathologists must provide detailed descriptions to support coding decisions.

Coding Guidelines

Inclusion Criteria

Use D47 When
  • According to the official coding guidelines, D47 should be used when the neoplasm's behavior is uncertain and cannot be classified as benign or malignant
  • Coders must ensure that the documentation supports the diagnosis and reflects the uncertainty of behavior

Exclusion Criteria

Do NOT use D47 When
No specific exclusions found.

Related CPT Codes

88305CPT Code

Pathology examination, surgical

Clinical Scenario

Used when a biopsy is performed to evaluate a neoplasm of uncertain behavior.

Documentation Requirements

Pathology report must clearly indicate findings and support the diagnosis.

Specialty Considerations

Pathologists should ensure detailed descriptions to aid in accurate coding.

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 of patient outcomes 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 of patient outcomes and resource allocation.

Reimbursement & Billing Impact

reimbursement.

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 D47?

Coding D47 is crucial for accurately representing neoplasms of uncertain behavior, which require careful monitoring and management. It ensures appropriate treatment plans and reimbursement.