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ICD-10 Guide
ICD-10 CodesD47.09

D47.09

Billable

Other mast cell neoplasms of uncertain behavior

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

Code Description

ICD-10 D47.09 is a billable code used to indicate a diagnosis of other mast cell neoplasms of uncertain behavior.

Key Diagnostic Point:

Mast cell neoplasms are a group of disorders characterized by the abnormal proliferation of mast cells, which are a type of white blood cell involved in allergic responses and immune regulation. The term 'other mast cell neoplasms of uncertain behavior' refers to neoplasms that do not fit into the more clearly defined categories of mastocytosis or mast cell leukemia. These neoplasms may present with a variety of symptoms, including skin lesions, gastrointestinal disturbances, and systemic symptoms such as anaphylaxis or flushing. The behavior of these neoplasms is classified as uncertain, indicating that their potential for malignancy or progression is not well understood. Surveillance is critical for these patients, as there is a risk of progression to more aggressive forms of mast cell disease. Regular monitoring through clinical evaluations, laboratory tests, and imaging studies may be necessary to assess disease progression and manage symptoms effectively. The complexity of diagnosing and managing these neoplasms requires a multidisciplinary approach, often involving hematologists, oncologists, and allergists to ensure comprehensive care.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and symptoms
  • Need for comprehensive diagnostic workup
  • Potential for progression to more aggressive forms
  • Lack of standardized treatment protocols

Audit Risk Factors

  • Inconsistent documentation of symptoms and clinical findings
  • Failure to document surveillance and follow-up plans
  • Misclassification of neoplasm behavior
  • Inadequate justification for the use of this specific code

Specialty Focus

Medical Specialties

Hematology/Oncology

Documentation Requirements

Detailed clinical notes on patient history, diagnostic tests, and treatment plans.

Common Clinical Scenarios

Patients presenting with unexplained skin lesions or systemic symptoms requiring evaluation for mast cell neoplasms.

Billing Considerations

Ensure comprehensive documentation of all diagnostic tests and interdisciplinary consultations.

Allergy and Immunology

Documentation Requirements

Records of allergic reactions, skin tests, and any relevant immunological assessments.

Common Clinical Scenarios

Patients with recurrent anaphylaxis or unexplained allergic symptoms.

Billing Considerations

Document any correlation between mast cell neoplasms and allergic symptoms.

Coding Guidelines

Inclusion Criteria

Use D47.09 When
  • According to ICD
  • 10 coding guidelines, D47
  • 09 should be used when a patient has a confirmed diagnosis of a mast cell neoplasm that does not fit into other specified categories
  • Documentation must support the diagnosis and indicate the uncertain behavior of the neoplasm

Exclusion Criteria

Do NOT use D47.09 When
  • Exclusion criteria include clearly defined mastocytosis or other hematological malignancies

Related ICD-10 Codes

Related CPT Codes

88305CPT Code

Pathology examination, surgical

Clinical Scenario

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

Documentation Requirements

Pathology report must be included in the patient's medical record.

Specialty Considerations

Ensure that the pathology report clearly indicates the presence of mast cells and their behavior.

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 diagnoses and treatment tracking. D47.09 provides a distinct classification for neoplasms of uncertain behavior, which was less clearly 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 diagnoses and treatment tracking. D47.09 provides a distinct classification for neoplasms of uncertain behavior, which was less clearly defined in ICD-9.

Reimbursement & Billing Impact

reimbursement.

Resources

Clinical References

  • •
    Mast Cell Disorders: A Comprehensive Guide

Coding & Billing References

  • •
    Mast Cell Disorders: A Comprehensive Guide

Frequently Asked Questions

What are the common symptoms associated with D47.09?

Common symptoms include skin lesions, gastrointestinal issues, and systemic reactions such as flushing or anaphylaxis. These symptoms can vary widely among patients.

How often should patients with D47.09 be monitored?

Patients should be monitored regularly, with follow-up appointments every 3-6 months, depending on the severity of symptoms and clinical findings.