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

ICD-10 D47.01

Billable / Specific CC

Cutaneous mastocytosis

D47
Block
5
Synonyms
1,125
LCDs
23
Payer Policies
0
Linked CPTs

About ICD-10-CM D47.01

ICD-10-CM code D47.01 represents Cutaneous mastocytosis. This is a billable/specific code in the Neoplasms chapter (block D47). The 2026 edition of ICD-10-CM D47.01 became effective on October 1, 2025.

Coding Tips for D47.01

Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.

Inpatient DRG impact: CC

D47.01 is designated CC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-CC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag CC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under D47.01. Per CMS ICD-10-CM Tabular 2026.

  • Diffuse cutaneous mastocytosis
  • Maculopapular cutaneous mastocytosis
  • Solitary mastocytoma
  • Telangiectasia macularis eruptiva perstans
  • Urticaria pigmentosa

Type 1 Excludes

Pure excludes, these codes can never be coded together with D47.01. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • congenital (diffuse) (maculopapular) cutaneous mastocytosis (Q82.2)
  • congenital urticaria pigmentosa (Q82.2)
  • extracutaneous mastocytoma (D47.09)

Inpatient DRG Impact, CC

codes Cutaneous mastocytosis. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.

Medicare LCD Coverage for D47.01

Local Coverage Determinations (LCDs) from CMS MACs that list D47.01 as a covered diagnosis.

1,125 LCDs

Showing top 10 of 1,125 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: MolDX: Lab-Developed Tests for Inherited Cancer Syndromes in Patients with Cancer
Article ID: 58679, Effective: 2026-02-05 00:00:00, 1346 covered, 0 non-covered
CPT 81215 →
CMS LCD: Billing and Coding: MolDX: Lab-Developed Tests for Inherited Cancer Syndromes in Patients with Cancer
Article ID: 58679, Effective: 2026-02-05 00:00:00, 1346 covered, 0 non-covered
CPT 81300 →
CMS LCD: Billing and Coding: MolDX: Lab-Developed Tests for Inherited Cancer Syndromes in Patients with Cancer
Article ID: 58679, Effective: 2026-02-05 00:00:00, 1346 covered, 0 non-covered
CPT 81351 →
CMS LCD: Billing and Coding: MolDX: Lab-Developed Tests for Inherited Cancer Syndromes in Patients with Cancer
Article ID: 58679, Effective: 2026-02-05 00:00:00, 1346 covered, 0 non-covered
CPT 81167 →
CMS LCD: Billing and Coding: MolDX: Lab-Developed Tests for Inherited Cancer Syndromes in Patients with Cancer
Article ID: 58679, Effective: 2026-02-05 00:00:00, 1346 covered, 0 non-covered
CPT 81405 →
CMS LCD: Billing and Coding: MolDX: Lab-Developed Tests for Inherited Cancer Syndromes in Patients with Cancer
Article ID: 58679, Effective: 2026-02-05 00:00:00, 1346 covered, 0 non-covered
CPT 0103U →
CMS LCD: Billing and Coding: MolDX: Lab-Developed Tests for Inherited Cancer Syndromes in Patients with Cancer
Article ID: 58679, Effective: 2026-02-05 00:00:00, 1346 covered, 0 non-covered
CPT 81201 →
CMS LCD: Billing and Coding: MolDX: Lab-Developed Tests for Inherited Cancer Syndromes in Patients with Cancer
Article ID: 58679, Effective: 2026-02-05 00:00:00, 1346 covered, 0 non-covered
CPT 81297 →
CMS LCD: Billing and Coding: MolDX: Lab-Developed Tests for Inherited Cancer Syndromes in Patients with Cancer
Article ID: 58679, Effective: 2026-02-05 00:00:00, 1346 covered, 0 non-covered
CPT 81298 →
CMS LCD: Billing and Coding: MolDX: Lab-Developed Tests for Inherited Cancer Syndromes in Patients with Cancer
Article ID: 58679, Effective: 2026-02-05 00:00:00, 1346 covered, 0 non-covered
CPT 81299 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing D47.01.

23 policies

1 Aetna

Allergy and Hypersensitivity - Medical Clinical Policy Bulletins | Aetna
Policy ID: CPB-0038

1 Cigna

Flow Cytometry - (0538)
Policy ID: MM_0538

5 Medicare

Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) - Policy Article
Policy ID: ART-52480
Billing and Coding: Lab: Flow Cytometry
Policy ID: ART-55717
Billing and Coding: Molecular Pathology Procedures
Policy ID: ART-56199
Billing and Coding: Removal of Benign and Malignant Skin Lesions
Policy ID: ART-56346
Billing and Coding: Erythropoiesis Stimulating Agents (ESA)
Policy ID: ART-56462

CPT Codes Commonly Billed with D47.01

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

No procedure linkages on file for D47.01

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 D47.01, Billing FAQ

Is ICD-10 code D47.01 billable? +

Yes, D47.01 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What other names or terms map to D47.01? +

ICD-10 D47.01 includes: Diffuse cutaneous mastocytosis; Maculopapular cutaneous mastocytosis; Solitary mastocytoma, and 2 more clinical synonyms.

What codes are Type 1 Excludes for D47.01? +

Type 1 Excludes (never code together with D47.01): congenital (diffuse) (maculopapular) cutaneous mastocytosis (Q82.2); congenital urticaria pigmentosa (Q82.2); extracutaneous mastocytoma (D47.09)

Is D47.01 a CC or MCC for inpatient DRG? +

Yes, this code is designated as CC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.

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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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