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

ICD-10 D49.3

Billable / Specific

Neoplasm of unspecified behavior of breast

D49
Block
0
Synonyms
185
LCDs
14
Payer Policies
0
Linked CPTs

About ICD-10-CM D49.3

ICD-10-CM code D49.3 represents Neoplasm of unspecified behavior of breast. This is a billable/specific code in the Neoplasms chapter (block D49). The 2026 edition of ICD-10-CM D49.3 became effective on October 1, 2025.

Type 1 Excludes

Pure excludes, these codes can never be coded together with D49.3. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • neoplasm of unspecified behavior of skin of breast (D49.2)

Medicare LCD Coverage for D49.3

Local Coverage Determinations (LCDs) from CMS MACs that list D49.3 as a covered diagnosis.

185 LCDs

Showing top 10 of 185 total . Click a CPT for full coverage scope.

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 →
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 77066 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing D49.3.

14 policies

5 Medicare

Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) - Policy Article
Policy ID: ART-52480
Billing and Coding: Biomarkers for Oncology
Policy ID: ART-52986
Billing and Coding: MolDX: bioTheranostics Cancer TYPE ID� Update
Policy ID: ART-53101
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 D49.3

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

No procedure linkages on file for D49.3

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.

Convert D49.3 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
D49.3 2393 00000

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

ICD-10 D49.3, Billing FAQ

Is ICD-10 code D49.3 billable? +

Yes, D49.3 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What codes are Type 1 Excludes for D49.3? +

Type 1 Excludes (never code together with D49.3): neoplasm of unspecified behavior of skin of breast (D49.2)

What ICD-9 codes does D49.3 map to? +

Per CMS GEMs, D49.3 maps to ICD-9 codes: 2393. 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 May 31, 2026.

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