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2025 ICD-10-CM code D47.09

Other mast cell neoplasms of uncertain behavior.These are tumors composed of mast cells that cannot be definitively classified as benign or malignant based on current histologic examination.

Code assignment should be based on the most definitive clinical and pathological information available. If a diagnosis of uncertain behavior is made, code D47.09 is assigned until further information is obtained. Do not code a diagnosis solely based on abnormal laboratory or imaging findings without corresponding pathological confirmation. Avoid using unspecified codes whenever possible and wait for more definitive diagnostic results.

Medical necessity for services related to this code is based on the evaluation and management of a suspected or confirmed neoplasm. The uncertainty in behavior necessitates further investigation to determine the appropriate course of treatment. Specific payer policies may require documentation justifying the need for diagnostic tests, consultations, and/or treatment related to the neoplasm.

Diagnosis is based on patient history, signs and symptoms, physical exam, and laboratory and imaging studies (CBC, LFTs, blood and urine tests for mast cell mediators and histamine metabolites, blood chemistry profile, genetic testing, skin/bone marrow biopsy, FNA, X-rays, ultrasound, CT scans, bone scans). Microscopic analysis may require expert consultation. Treatment may include close follow-up, supportive care, antihistamines, topical steroids, photochemotherapy, and epinephrine autoinjector (for anaphylaxis risk). Severe systemic cases may require interferon, immune modulators, or chemotherapy. Patients may be advised to avoid dietary and environmental triggers.

IMPORTANT:Excludes1: congenital cutaneous mastocytosis (Q82.2) and histiocytic neoplasms of uncertain behavior (D47.Z9).Use additional codes from Chapter 4 to identify any associated functional activity.For overlapping lesions, use subcategory .8

In simple words: This code refers to a growth of mast cells (a type of white blood cell) that can't be classified as clearly benign or cancerous yet based on current testing.

Other mast cell neoplasms of uncertain behavior refer to a pathological diagnosis that describes tumors which cannot be confirmed as benign or malignant based on histologic examination of cells from a biopsy specimen. The cell type cannot be definitively determined. Mast cells, also known as basophils, are white blood cells that produce histamine. This code represents a type of mast cell neoplasm of uncertain behavior not represented by another code, such as mastocytoma or mastocytosis NOS.

Example 1: A patient presents with itchy, pigmented skin patches that blister and bleed when scratched. Biopsy results are inconclusive for malignancy, showing features suggestive of a mast cell neoplasm but without definitive characteristics of either a benign or malignant tumor. D47.09 is assigned., A patient undergoes a bone marrow biopsy due to suspected mastocytosis. Pathology reveals an abnormal proliferation of mast cells, but the pathologist cannot definitively classify the lesion as benign or malignant. D47.09 is assigned., An incidental finding on a liver CT scan reveals a mass. Biopsy results are consistent with a mast cell neoplasm, but further studies are needed to determine whether the lesion is malignant.D47.09 is used until definitive diagnosis is reached.

Complete clinical documentation of the patient's signs and symptoms, physical examination findings, laboratory results (including CBC, LFTs, and tests for mast cell mediators), imaging studies (if performed), and pathology reports.If a definitive diagnosis is later determined, the code should be updated accordingly.

** It is important to note that the diagnosis of "other mast cell neoplasms of uncertain behavior" represents a diagnostic challenge.Clinicians should make every effort to obtain a definitive diagnosis, and the code should be updated once additional information becomes available. This code should not be used for coding purposes if a definitive diagnosis is available.This information is current as of November 30, 2024.

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