ICD-10 D37.0
Non-Billable HeaderNeoplasm of uncertain behavior of lip, oral cavity and pharynx
About ICD-10-CM D37.0
ICD-10-CM code D37.0 represents Neoplasm of uncertain behavior of lip, oral cavity and pharynx. This is a non-billable header code in the Neoplasms chapter (block D37). The 2026 edition of ICD-10-CM D37.0 became effective on October 1, 2025. Non-billable codes cannot be used as a primary or secondary diagnosis on a claim, use a more specific child code instead.
Type 1 Excludes
Pure excludes, these codes can never be coded together with D37.0. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- neoplasm of uncertain behavior of aryepiglottic fold or interarytenoid fold, laryngeal aspect (D38.0)
- neoplasm of uncertain behavior of epiglottis NOS (D38.0)
- neoplasm of uncertain behavior of skin of lip (D48.5)
- neoplasm of uncertain behavior of suprahyoid portion of epiglottis (D38.0)
Medicare LCD Coverage for D37.0
Local Coverage Determinations (LCDs) from CMS MACs that list D37.0 as a covered diagnosis.
This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing D37.0.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but D37.0 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with D37.0
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.
Codes Adjacent To D37.0
Other codes in section D37-D48 (Neoplasms of uncertain behavior, polycythemia vera and myelodysplastic syndromes).
ICD-10 D37.0, Billing FAQ
Is ICD-10 code D37.0 billable? +
No, D37.0 is a non-billable header code. Use a more specific child code from block D37 when submitting claims.
What codes are Type 1 Excludes for D37.0? +
Type 1 Excludes (never code together with D37.0): neoplasm of uncertain behavior of aryepiglottic fold or interarytenoid fold, laryngeal aspect (D38.0); neoplasm of uncertain behavior of epiglottis NOS (D38.0); neoplasm of uncertain behavior of skin of lip (D48.5)
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 1, 2026.
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