2025 ICD-10-CM code D48.7
Neoplasm of uncertain behavior of other specified sites, including eye, heart, and peripheral nerves of the orbit.This code excludes neoplasms of uncertain behavior of connective tissue (D48.1-) and skin of the eyelid (D48.5).
Medical necessity must be established for all procedures and treatments related to the neoplasm.The documentation must support the need for the specific interventions performed based on the diagnostic uncertainty.
Diagnosis involves physical exam, imaging (e.g., ultrasound, MRI, CT), laboratory tests, and biopsy.Treatment may range from watchful waiting to surgical removal combined with chemotherapy or radiation therapy depending on the definitive diagnosis.
- Chapter 2: Neoplasms (C00-D49)
- D48: Neoplasm of uncertain or unknown behaviour of other and unspecified sites
In simple words: This code indicates a tumor in a specific location like the eye, heart, or nerves around the eye, where doctors aren't sure if it's cancerous or not based on initial tests. Further examination and monitoring are usually needed.
This code represents a neoplasm of uncertain behavior located in sites other than those specifically classified elsewhere in the D48 series. Examples of such sites include the eye, heart, and peripheral nerves of the orbit.A neoplasm of uncertain behavior is one where a definitive diagnosis of benign or malignant cannot be made based on available histological evidence.
Example 1: A patient presents with blurred vision and an unusual growth in the eye. A biopsy is performed, but the pathologist cannot definitively classify the neoplasm as benign or malignant, leading to the assignment of D48.7., During a routine echocardiogram, a mass is detected in the heart. After further investigation and biopsy, the neoplasm's behavior remains uncertain, necessitating the use of code D48.7., A patient experiences numbness and pain around the eye. Imaging reveals a tumor involving the peripheral nerves of the orbit.Biopsy results are inconclusive, leading to a diagnosis of a neoplasm of uncertain behavior and the assignment of D48.7.
Complete clinical documentation should include details of the patient's presenting symptoms, physical examination findings, imaging studies (e.g., ultrasound, CT, MRI), laboratory test results, biopsy procedure notes, and pathology reports.The documentation must support the diagnostic uncertainty of the neoplasm's behavior.
- Payment Status: Active
- Specialties:Oncology, Pathology, Ophthalmology, Cardiology, Neurology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Physician's Office, Independent Clinic