D48.9: Neoplasm of uncertain behavior, unspecified
D48.9, neoplasm of uncertain behavior, unspecified, is listed as a covered diagnosis in 3 Medicare billing and coding articles that apply to 21 HCPCS Level II codes, including Q9957 (Injection, perflutren lipid microspheres, per ml), Q9956 (Injection, octafluoropropane microspheres, per ml), C8925 (Transesophageal echocardiography (tee) with contrast, or…). The articles come from 2 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 D48.9 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| Q9957 | Injection, perflutren lipid microspheres, per ml | Carrier judgment | — | 1 |
| Q9956 | Injection, octafluoropropane microspheres, per ml | Carrier judgment | — | 1 |
| C8925 | Transesophageal echocardiography (tee) with contrast, or without contrast followed by with contrast, real time with image documentation (2d) (with or without m-mode recording); including probe placement, image acquisition, interpretation and report | Special coverage instructions apply | — | 1 |
| C8926 | Transesophageal echocardiography (tee) with contrast, or without contrast followed by with contrast, for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report | Special coverage instructions apply | — | 1 |
| C8927 | Transesophageal echocardiography (tee) with contrast, or without contrast followed by with contrast, for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (dynamically changing) cardiac pumping function and to therapeutic measures on an immediate time basis | Special coverage instructions apply | — | 1 |
| Q9955 | Injection, perflexane lipid microspheres, per ml | Carrier judgment | — | 1 |
| J8999 | Prescription drug, oral, chemotherapeutic, nos | Special coverage instructions apply | — | 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 |
| J8530 | Cyclophosphamide; oral, 25 mg | Special coverage instructions apply | — | 1 |
| J8597 | Antiemetic drug, oral, not otherwise specified | Special coverage instructions apply | — | 1 |
| J8610 | Methotrexate; oral, 2.5 mg | Special coverage instructions apply | — | 1 |
| J8498 | Antiemetic drug, rectal/suppository, not otherwise specified | Special coverage instructions apply | — | 1 |
| J0881 | Injection, darbepoetin alfa, 1 microgram (non-esrd use) | Special coverage instructions apply | — | 1 |
| J0885 | Injection, epoetin alfa, (for non-esrd use), 1000 units | Special coverage instructions apply | — | 1 |
| Q5106 | Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for non-esrd use), 1000 units | Special coverage instructions apply | — | 1 |
| J0882 | Injection, darbepoetin alfa, 1 microgram (for esrd on dialysis) | Special coverage instructions apply | — | 1 |
| Q5105 | Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for esrd on dialysis), 100 units | Special coverage instructions apply | — | 1 |
| J0890 | Injection, peginesatide, 0.1 mg (for esrd on dialysis) | Carrier judgment | — | 1 |
| Q4081 | Injection, epoetin alfa, 100 units (for esrd on dialysis) | Special coverage instructions apply | — | 1 |
| A9270 | Non-covered item or service | Non-covered by Medicare | Not covered | 1 |
Medicare policy articles listing D48.9
- A56505: Billing and Coding: Transesophageal Echocardiography (TEE) (Novitas Solutions, Inc. (MAC - Part A, MAC - Part B); 6 Level II codes). LCD with the same title: L33579, L34337, L35016
- A52479: Oral Anticancer Drugs - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC); 8 Level II codes). LCD with the same title: L33826
- A56462: Billing and Coding: Erythropoiesis Stimulating Agents (ESA) (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 7 Level II codes). LCD with the same title: L34356
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 D48 diagnoses (Neoplasm of uncertain behavior of other and unspecified sites)
- D48.0 — Neoplasm of uncertain behavior of bone and articular cartilage
- D48.110 — Desmoid tumor of head and neck
- D48.111 — Desmoid tumor of chest wall
- D48.112 — Desmoid tumor, intrathoracic
- D48.113 — Desmoid tumor of abdominal wall
- D48.114 — Desmoid tumor, intraabdominal
- D48.115 — Desmoid tumor of upper extremity and shoulder girdle
- D48.116 — Desmoid tumor of lower extremity and pelvic girdle
- D48.117 — Desmoid tumor of back
- D48.118 — Desmoid tumor of other site
- D48.119 — Desmoid tumor of unspecified site
- D48.19 — Other specified neoplasm of uncertain behavior of connective and…
- D48.2 — Neoplasm of uncertain behavior of peripheral nerves and autonomic…
- D48.3 — Neoplasm of uncertain behavior of retroperitoneum
- D48.4 — Neoplasm of uncertain behavior of peritoneum
- D48.5 — Neoplasm of uncertain behavior of skin
- D48.61 — Neoplasm of uncertain behavior of right breast
- D48.62 — Neoplasm of uncertain behavior of left breast
- D48.7 — Neoplasm of uncertain behavior of other specified sites
Frequently asked questions
Does Medicare cover D48.9 (Neoplasm of uncertain behavior, unspecified)?
Medicare covers items and services, not diagnoses. 3 Medicare billing and coding articles list D48.9 as a covered diagnosis for 21 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 D48.9?
The Level II codes from the policies most specific to this diagnosis are Q9957 (Injection, perflutren lipid microspheres, per ml, 1 article); Q9956 (Injection, octafluoropropane microspheres, per ml, 1 article); C8925 (Transesophageal echocardiography (tee) with contrast, or…, 1 article); C8926 (Transesophageal echocardiography (tee) with contrast, or…, 1 article); C8927 (Transesophageal echocardiography (tee) with contrast, or…, 1 article). Code choice depends on the item supplied; check each code's descriptor.
Which Medicare policy articles list D48.9?
A56505 (Billing and Coding: Transesophageal Echocardiography (TEE)); A52479 (Oral Anticancer Drugs - Policy Article); A56462 (Billing and Coding: Erythropoiesis Stimulating Agents (ESA)).
What is ICD-10-CM code D48.9?
D48.9 is the ICD-10-CM code for neoplasm of uncertain behavior, unspecified, in category D48 (Neoplasm of uncertain behavior of other and unspecified sites), chapter 2: Neoplasms.
Next steps
- Run a reimbursement report for a device billed under Q9957
- Watch Q9957 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for Q9957
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.