D43.9: Neoplasm of uncertain behavior of central nervous system, unspecified
D43.9, neoplasm of uncertain behavior of central nervous system, unspecified, is listed as a covered diagnosis in 4 Medicare billing and coding articles that apply to 38 HCPCS Level II codes, including G0453 (Continuous intraoperative neurophysiology monitoring, from…), Q0512 (Pharmacy supply fee for oral anti-cancer, oral anti-emetic…), Q0511 (Pharmacy supply fee for oral anti-cancer, oral anti-emetic…). 4 of these codes have a 2026 DMEPOS fee schedule amount; E0783 pays $9,917.33 to $11,667.45 (NU) depending on the state. 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 D43.9 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| G0453 | Continuous intraoperative neurophysiology monitoring, from outside the operating room (remote or nearby), per patient, (attention directed exclusively to one patient) each 15 minutes (list in addition to primary procedure) | Carrier judgment | — | 1 |
| Q0512 | Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period | Special coverage instructions apply | — | 1 |
| Q0511 | Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period | Special coverage instructions apply | — | 1 |
| Q0162 | Ondansetron 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 regimen | Special coverage instructions apply | — | 1 |
| J8540 | Dexamethasone, oral, 0.25 mg | Special coverage instructions apply | — | 1 |
| Q0166 | Granisetron 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 regimen | Special coverage instructions apply | — | 1 |
| J8501 | Aprepitant, oral, 5 mg | Special coverage instructions apply | — | 1 |
| Q0164 | Prochlorperazine 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 regimen | Special coverage instructions apply | — | 1 |
| Q0163 | Diphenhydramine 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 regimen | Special coverage instructions apply | — | 1 |
| J8655 | Netupitant 300 mg and palonosetron 0.5 mg, oral | Special coverage instructions apply | — | 1 |
| J8670 | Rolapitant, oral, 1 mg | Special coverage instructions apply | — | 1 |
| Q0155 | Dronabinol (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 regimen | Special coverage instructions apply | — | 1 |
| Q0161 | Chlorpromazine 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 regimen | Carrier judgment | — | 1 |
| Q0167 | Dronabinol, 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 regimen | Special coverage instructions apply | — | 1 |
| Q0169 | Promethazine 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 regimen | Special coverage instructions apply | — | 1 |
| Q0173 | Trimethobenzamide 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 regimen | Special coverage instructions apply | — | 1 |
| Q0175 | Perphenazine, 4 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 regimen | Special coverage instructions apply | — | 1 |
| Q0177 | Hydroxyzine pamoate, 25 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 regimen | Special coverage instructions apply | — | 1 |
| Q0180 | Dolasetron mesylate, 100 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 regimen | Special coverage instructions apply | — | 1 |
| Q0181 | Unspecified oral dosage form, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for a iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen | Special coverage instructions apply | — | 1 |
| E0783 | Infusion pump system, implantable, programmable (includes all components, e.g., pump, catheter, connectors, etc.) | Special coverage instructions apply | $9,917.33–$11,667.45 (NU) | 1 |
| E0786 | Implantable programmable infusion pump, replacement (excludes implantable intraspinal catheter) | Special coverage instructions apply | $10,969.75–$11,380.88 (NU) | 1 |
| E0782 | Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.) | Special coverage instructions apply | $5,200.92–$6,118.73 (NU) | 1 |
| E0785 | Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement | Special coverage instructions apply | $572.38–$673.39 (KF) | 1 |
| J7999 | Compounded drug, not otherwise classified | Special coverage instructions apply | — | 1 |
13 more codes are listed. See every code with payment by region in Caduvo.
Medicare policy articles listing D43.9
- A56722: Billing and Coding: Intraoperative Neurophysiological Testing (Novitas Solutions, Inc. (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L34623, L35003
- A52480: Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC); 19 Level II codes). LCD with the same title: L33827
- A56695: Billing and Coding: Implantable Infusion Pump (Palmetto GBA (MAC - Part B); 9 Level II codes). LCD with the same title: L33461
- A56612: Billing and Coding: CT of the Head (Palmetto GBA (MAC - Part A, MAC - Part B); 9 Level II codes). LCD with the same title: L34417
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 D43 diagnoses (Neoplasm of uncertain behavior of brain and central nervous system)
- D43.0 — Neoplasm of uncertain behavior of brain, supratentorial
- D43.1 — Neoplasm of uncertain behavior of brain, infratentorial
- D43.2 — Neoplasm of uncertain behavior of brain, unspecified
- D43.3 — Neoplasm of uncertain behavior of cranial nerves
- D43.4 — Neoplasm of uncertain behavior of spinal cord
- D43.8 — Neoplasm of uncertain behavior of other specified parts of central…
Frequently asked questions
Does Medicare cover D43.9 (Neoplasm of uncertain behavior of central nervous system…)?
Medicare covers items and services, not diagnoses. 4 Medicare billing and coding articles list D43.9 as a covered diagnosis for 38 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 D43.9?
The Level II codes from the policies most specific to this diagnosis are G0453 (Continuous intraoperative neurophysiology monitoring, from…, 1 article); Q0512 (Pharmacy supply fee for oral anti-cancer, oral anti-emetic…, 1 article); Q0511 (Pharmacy supply fee for oral anti-cancer, oral anti-emetic…, 1 article); Q0162 (Ondansetron 1 mg, oral, fda approved prescription…, 1 article); J8540 (Dexamethasone, oral, 0.25 mg, 1 article). Code choice depends on the item supplied; check each code's descriptor.
What does Medicare pay for equipment billed with D43.9?
Under the 2026 DMEPOS fee schedule (non-rural state fees): E0783 $9,917.33 to $11,667.45 (NU); E0786 $10,969.75 to $11,380.88 (NU); E0782 $5,200.92 to $6,118.73 (NU); E0785 $572.38 to $673.39 (KF). Medicare pays 80% of the allowed amount after the Part B deductible.
Which Medicare policy articles list D43.9?
A56722 (Billing and Coding: Intraoperative Neurophysiological Testing); A52480 (Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) - Policy Article); A56695 (Billing and Coding: Implantable Infusion Pump), and 1 more article.
What is ICD-10-CM code D43.9?
D43.9 is the ICD-10-CM code for neoplasm of uncertain behavior of central nervous system, unspecified, in category D43 (Neoplasm of uncertain behavior of brain and central nervous system), chapter 2: Neoplasms.
Next steps
- Run a reimbursement report for a device billed under G0453
- Watch G0453 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for G0453
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.