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2025 ICD-10-CM code D47.Z

Neoplasms of uncertain behavior of lymphoid, hematopoietic and related tissue, not elsewhere classified.

Use this code only when a definitive diagnosis of a benign or malignant neoplasm cannot be made. Do not use this code if a more specific code is available. If a more specific diagnosis becomes available later, update the coding accordingly.An additional code from Chapter 4 may be used to identify functional activity associated with the neoplasm.

Medical necessity depends on the underlying condition causing the uncertain behavior classification.Further investigation to establish a definitive diagnosis is generally medically necessary to guide appropriate treatment.

Diagnosis and management are typically overseen by hematologists/oncologists.The diagnostic process involves physical examination, laboratory tests (e.g., CBC, peripheral blood smear, chemistry profile), biopsy or fine needle aspiration of the tumor, microscopic histology and cytology, genetic analysis, and imaging studies (e.g., ultrasound, CT, MRI, PET scans). Treatment may involve watchful waiting, surgical excision, antiviral therapy, radiation therapy, or chemotherapy, depending on the specific diagnosis.

In simple words: This code represents a diagnosis of a tumor in the lymph or blood-forming tissues that cannot be classified as clearly benign or malignant based on initial testing.Further investigation is usually required.

Other specified neoplasms of uncertain behavior of lymphoid, hematopoietic and related tissue 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. This subcategory includes codes for specific types of neoplasms of uncertain behavior of lymphoid, hematopoietic or related tissue, such as post–transplant lymphoproliferative disorder (PTLD) and Castleman disease, not included in other categories.

Example 1: A patient presents with enlarged lymph nodes and fatigue. Biopsy results are inconclusive, showing atypical lymphoid cells that cannot be definitively classified as benign or malignant. D47.Z is used until further tests determine the exact nature of the neoplasm., Following an organ transplant, a patient develops features suggestive of post-transplant lymphoproliferative disorder (PTLD).Initial biopsy findings are inconclusive. D47.Z is assigned while awaiting further workup to confirm PTLD., A patient presents with systemic symptoms and lymphadenopathy. Imaging reveals a mass suggestive of Castleman disease. However, the initial biopsy is non-diagnostic, showing features of a lymphoproliferative disorder but not definitively characterizing it. D47.Z is used while additional tests, such as immunohistochemistry and flow cytometry, are performed.

Complete clinical workup including history, physical exam findings, laboratory results (CBC, blood smear, chemistry profile), imaging reports (ultrasound, CT, MRI, PET scan as appropriate), and pathology reports from biopsy/aspiration. If further testing is pending, this should be documented.

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