ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 D38

Non-Billable Header

Neoplasm of uncertain behavior of middle ear and respiratory and intrathoracic organs

D38
Block
0
Synonyms
0
LCDs
0
Payer Policies
0
Linked CPTs

About ICD-10-CM D38

ICD-10-CM code D38 represents Neoplasm of uncertain behavior of middle ear and respiratory and intrathoracic organs. This is a non-billable header code in the Neoplasms chapter (block D38). The 2026 edition of ICD-10-CM D38 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 D38. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • neoplasm of uncertain behavior of heart (D48.7)

Medicare LCD Coverage for D38

Local Coverage Determinations (LCDs) from CMS MACs that list D38 as a covered diagnosis.

No Medicare LCDs reference D38 as covered

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 D38.

No commercial payer policies reference D38 on file

Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but D38 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.

CPT Codes Commonly Billed with D38

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

No procedure linkages on file for D38

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.

ICD-10 D38, Billing FAQ

Is ICD-10 code D38 billable? +

No, D38 is a non-billable header code. Use a more specific child code from block D38 when submitting claims.

What codes are Type 1 Excludes for D38? +

Type 1 Excludes (never code together with D38): neoplasm of uncertain behavior of heart (D48.7)

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on May 31, 2026.

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