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

ICD-10 D48.5

Billable / Specific

Neoplasm of uncertain behavior of skin

D48
Block
4
Synonyms
856
LCDs
39
Payer Policies
7
Linked CPTs

About ICD-10-CM D48.5

ICD-10-CM code D48.5 represents Neoplasm of uncertain behavior of skin. This is a billable/specific code in the Neoplasms chapter (block D48). The 2026 edition of ICD-10-CM D48.5 became effective on October 1, 2025.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under D48.5. Per CMS ICD-10-CM Tabular 2026.

  • Neoplasm of uncertain behavior of anal margin
  • Neoplasm of uncertain behavior of anal skin
  • Neoplasm of uncertain behavior of perianal skin
  • Neoplasm of uncertain behavior of skin of breast

Type 1 Excludes

Pure excludes, these codes can never be coded together with D48.5. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • neoplasm of uncertain behavior of anus NOS (D37.8)
  • neoplasm of uncertain behavior of skin of genital organs (D39.8, D40.8)
  • neoplasm of uncertain behavior of vermilion border of lip (D37.0)

Medicare LCD Coverage for D48.5

Local Coverage Determinations (LCDs) from CMS MACs that list D48.5 as a covered diagnosis.

856 LCDs

Showing top 10 of 856 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: MolDX: Pigmented Lesion Assay
Article ID: 57983, Effective: 2023-12-28 00:00:00, 1 covered, 0 non-covered
CPT 0089U →
CMS LCD: Billing and Coding: Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography
Article ID: 56448, Effective: 2025-12-04 00:00:00, 156 covered, 0 non-covered
CPT 77063 →
CMS LCD: Billing and Coding: Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography
Article ID: 56448, Effective: 2025-12-04 00:00:00, 156 covered, 0 non-covered
CPT C8905 →
CMS LCD: Billing and Coding: Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography
Article ID: 56448, Effective: 2025-12-04 00:00:00, 156 covered, 0 non-covered
CPT 77065 →
CMS LCD: Billing and Coding: Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography
Article ID: 56448, Effective: 2025-12-04 00:00:00, 156 covered, 0 non-covered
CPT 76641 →
CMS LCD: Billing and Coding: Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography
Article ID: 56448, Effective: 2025-12-04 00:00:00, 156 covered, 0 non-covered
CPT 77054 →
CMS LCD: Billing and Coding: Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography
Article ID: 56448, Effective: 2025-12-04 00:00:00, 156 covered, 0 non-covered
CPT 77047 →
CMS LCD: Billing and Coding: Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography
Article ID: 56448, Effective: 2025-12-04 00:00:00, 156 covered, 0 non-covered
CPT 77049 →
CMS LCD: Billing and Coding: Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography
Article ID: 56448, Effective: 2025-12-04 00:00:00, 156 covered, 0 non-covered
CPT C8903 →
CMS LCD: Billing and Coding: Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography
Article ID: 56448, Effective: 2025-12-04 00:00:00, 156 covered, 0 non-covered
CPT C8906 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing D48.5.

39 policies

1 Aetna

Septoplasty and Rhinoplasty - Medical Clinical Policy Bulletins | Aetna
Policy ID: CPB-0005

5 Medicare

Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) - Policy Article
Policy ID: ART-52480
Billing and Coding: MolDX: bioTheranostics Cancer TYPE ID� Update
Policy ID: ART-53101
Billing and Coding: Mohs Micrographic Surgery (MMS)
Policy ID: ART-53883
Billing and Coding: MolDX: bioTheranostics Cancer TYPE ID�
Policy ID: ART-54188
Billing and Coding: MolDX: bioTheranostics Cancer TYPE ID� Update
Policy ID: ART-54386

CPT Codes Commonly Billed with D48.5

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

7 linkages
  • 11102 Skin biopsy — uncertain neoplasm, seborrheic keratosis, nevi, cyst, mass Dermatology
  • 11102 Tangential skin biopsy — uncertain neoplasm skin, actinic keratosis, melanocytic nevi, skin cancer, melanoma, psoriasis, discoid lupus, skin disorder, rash, seborrheic keratosis, benign neoplasm, dermatitis, prurigo, dermatitis herpetiformis Dermatology
  • 11104 Punch biopsy skin — uncertain skin neoplasm, skin cancer, melanoma, nevi, psoriasis, lupus, connective tissue disorder, pemphigus, bullous pemphigoid Dermatology
  • 11106 Incisional biopsy skin — uncertain neoplasm, skin cancer, melanoma, nevi, actinic keratosis, BCC/SCC by site Dermatology
  • 0089U CMS LCD: Billing and Coding: MolDX: Pigmented Lesion Assay CMS LCD
  • 0314U CMS LCD: Billing and Coding: MolDX: Molecular Assays for the Diagnosis of Cutaneous Melanoma CMS LCD
  • 0090U CMS LCD: Billing and Coding: MolDX: Molecular Assays for the Diagnosis of Cutaneous Melanoma CMS LCD

Convert D48.5 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
D48.5 2382 00000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 D48.5, Billing FAQ

Is ICD-10 code D48.5 billable? +

Yes, D48.5 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 D48.5? +

ICD-10 D48.5 includes: Neoplasm of uncertain behavior of anal margin; Neoplasm of uncertain behavior of anal skin; Neoplasm of uncertain behavior of perianal skin, and 1 more clinical synonyms.

What codes are Type 1 Excludes for D48.5? +

Type 1 Excludes (never code together with D48.5): neoplasm of uncertain behavior of anus NOS (D37.8); neoplasm of uncertain behavior of skin of genital organs (D39.8, D40.8); neoplasm of uncertain behavior of vermilion border of lip (D37.0)

What CPT codes are commonly billed with D48.5? +

Procedures frequently paired with D48.5 include: 11102, 11102, 11104, 11106, 0089U.

What ICD-9 codes does D48.5 map to? +

Per CMS GEMs, D48.5 maps to ICD-9 codes: 2382. Useful for legacy data review and historical claim analysis.

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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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