D37.9: Neoplasm of uncertain behavior of digestive organ, unspecified

D37.9, neoplasm of uncertain behavior of digestive organ, unspecified, is listed as a covered diagnosis in 4 Medicare billing and coding articles that apply to 30 HCPCS Level II codes, including Q0512 (Pharmacy supply fee for oral anti-cancer, oral anti-emetic…), Q0511 (Pharmacy supply fee for oral anti-cancer, oral anti-emetic…), G0105 (Colorectal cancer screening; colonoscopy on individual at…). The articles come from 3 Medicare contractors. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.

HCPCS Level II codes with D37.9 as a covered diagnosis

CodeDescriptionMedicare coverageDMEPOS fee 2026 (state range)Articles listing it
Q0512Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day periodSpecial coverage instructions apply—2
Q0511Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day periodSpecial coverage instructions apply—2
G0105Colorectal cancer screening; colonoscopy on individual at high riskSpecial coverage instructions apply—1
G9998Documentation of medical reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., last colonoscopy incomplete, last colonoscopy had inadequate prep, piecemeal removal of adenomas, or sessile serrated polyps >= 20 mm in size, last colonoscopy found greater than 10 adenomas, lower gastrointestinal bleeding, or patient at high risk for colon cancer due to underlying medical history ([i.e. crohn's disease, ulcerative colitis, personal or family history of colon cancer, hereditary colorectal cancer syndromes])Carrier judgment—1
G9999Documentation of system reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., unable to locate previous colonoscopy report, patient cannot provide precise date or details from previous colonoscopy, previous colonoscopy report was incomplete)Carrier judgment—1
J9267Injection, paclitaxel, 1 mgSpecial coverage instructions apply—1
J9264Injection, paclitaxel protein-bound particles, 1 mgCarrier judgment—1
J8999Prescription drug, oral, chemotherapeutic, nosSpecial coverage instructions apply—1
J8530Cyclophosphamide; oral, 25 mgSpecial coverage instructions apply—1
J8597Antiemetic drug, oral, not otherwise specifiedSpecial coverage instructions apply—1
J8610Methotrexate; oral, 2.5 mgSpecial coverage instructions apply—1
J8498Antiemetic drug, rectal/suppository, not otherwise specifiedSpecial coverage instructions apply—1
Q0162Ondansetron 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimenSpecial coverage instructions apply—1
J8540Dexamethasone, oral, 0.25 mgSpecial coverage instructions apply—1
Q0166Granisetron hydrochloride, 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 24 hour dosage regimenSpecial coverage instructions apply—1
J8501Aprepitant, oral, 5 mgSpecial coverage instructions apply—1
Q0164Prochlorperazine maleate, 5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimenSpecial coverage instructions apply—1
Q0163Diphenhydramine hydrochloride, 50 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at time of chemotherapy treatment not to exceed a 48 hour dosage regimenSpecial coverage instructions apply—1
J8655Netupitant 300 mg and palonosetron 0.5 mg, oralSpecial coverage instructions apply—1
J8670Rolapitant, oral, 1 mgSpecial coverage instructions apply—1
Q0155Dronabinol (syndros), 0.1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimenSpecial coverage instructions apply—1
Q0161Chlorpromazine hydrochloride, 5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimenCarrier judgment—1
Q0167Dronabinol, 2.5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimenSpecial coverage instructions apply—1
Q0169Promethazine hydrochloride, 12.5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimenSpecial coverage instructions apply—1
Q0173Trimethobenzamide hydrochloride, 250 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimenSpecial coverage instructions apply—1

5 more codes are listed. See every code with payment by region in Caduvo.

Medicare policy articles listing D37.9

A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.

Other D37 diagnoses (Neoplasm of uncertain behavior of oral cavity and digestive organs)

Frequently asked questions

Does Medicare cover D37.9 (Neoplasm of uncertain behavior of digestive organ…)?

Medicare covers items and services, not diagnoses. 4 Medicare billing and coding articles list D37.9 as a covered diagnosis for 30 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.

Which HCPCS codes can be billed with ICD-10 D37.9?

The Level II codes from the policies most specific to this diagnosis are Q0512 (Pharmacy supply fee for oral anti-cancer, oral anti-emetic…, 2 articles); Q0511 (Pharmacy supply fee for oral anti-cancer, oral anti-emetic…, 2 articles); G0105 (Colorectal cancer screening; colonoscopy on individual at…, 1 article); G9998 (Documentation of medical reason(s) for an interval of less…, 1 article); G9999 (Documentation of system reason(s) for an interval of less…, 1 article). Code choice depends on the item supplied; check each code's descriptor.

Which Medicare policy articles list D37.9?

A56632 (Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy); A52450 (Billing and Coding: Paclitaxel (e.g., Taxol®/Abraxane ™)); A52479 (Oral Anticancer Drugs - Policy Article), and 1 more article.

What is ICD-10-CM code D37.9?

D37.9 is the ICD-10-CM code for neoplasm of uncertain behavior of digestive organ, unspecified, in category D37 (Neoplasm of uncertain behavior of oral cavity and digestive organs), chapter 2: Neoplasms.

Next steps

Sources: CMS Medicare Coverage Database billing and coding articles (covered ICD-10 code lists and HCPCS links); ICD-10-CM FY2026; CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026 (non-rural state fees). Not billing or legal advice.

Chapter 2: Neoplasms · All diagnoses · HCPCS lookup