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

ICD-10 D49.81

Billable / Specific

Neoplasm of unspecified behavior of retina and choroid

D49
Block
2
Synonyms
176
LCDs
19
Payer Policies
11
Linked CPTs

About ICD-10-CM D49.81

ICD-10-CM code D49.81 represents Neoplasm of unspecified behavior of retina and choroid. This is a billable/specific code in the Neoplasms chapter (block D49). The 2026 edition of ICD-10-CM D49.81 became effective on October 1, 2025.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under D49.81. Per CMS ICD-10-CM Tabular 2026.

  • Dark area on retina
  • Retinal freckle

Medicare LCD Coverage for D49.81

Local Coverage Determinations (LCDs) from CMS MACs that list D49.81 as a covered diagnosis.

176 LCDs

Showing top 10 of 176 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
Article ID: 53060, Effective: 2025-10-01 00:00:00, 1692 covered, 0 non-covered
CPT 92201 →
CMS LCD: Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
Article ID: 53060, Effective: 2025-10-01 00:00:00, 1692 covered, 0 non-covered
CPT 92250 →
CMS LCD: Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
Article ID: 53060, Effective: 2025-10-01 00:00:00, 1692 covered, 0 non-covered
CPT 92202 →
CMS LCD: Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
Article ID: 53060, Effective: 2025-10-01 00:00:00, 1692 covered, 0 non-covered
CPT 92227 →
CMS LCD: Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
Article ID: 53060, Effective: 2025-10-01 00:00:00, 1692 covered, 0 non-covered
CPT 92228 →
CMS LCD: Billing and Coding: Magnetic Resonance Angiography
Article ID: 56775, Effective: 2025-10-01 00:00:00, 1311 covered, 0 non-covered
CPT C8918 →
CMS LCD: Billing and Coding: Magnetic Resonance Angiography
Article ID: 56775, Effective: 2025-10-01 00:00:00, 1311 covered, 0 non-covered
CPT C8936 →
CMS LCD: Billing and Coding: Magnetic Resonance Angiography
Article ID: 56775, Effective: 2025-10-01 00:00:00, 1311 covered, 0 non-covered
CPT C8910 →
CMS LCD: Billing and Coding: Magnetic Resonance Angiography
Article ID: 56775, Effective: 2025-10-01 00:00:00, 1311 covered, 0 non-covered
CPT 70548 →
CMS LCD: Billing and Coding: Magnetic Resonance Angiography
Article ID: 56775, Effective: 2025-10-01 00:00:00, 1311 covered, 0 non-covered
CPT C8913 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing D49.81.

19 policies

5 Medicare

Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) - Policy Article
Policy ID: ART-52480
Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
Policy ID: ART-53060
Billing and Coding: Erythropoiesis Stimulating Agents (ESA)
Policy ID: ART-56462
Billing and Coding: Flow Cytometry
Policy ID: ART-56464
Billing and Coding: Transesophageal Echocardiography (TEE)
Policy ID: ART-56505

1 Aetna

Fundus Photography
Policy ID: CPB-0539

CPT Codes Commonly Billed with D49.81

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

11 linkages
  • 92228 CMS LCD: Billing and Coding: Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy and Fundus Photography) CMS LCD
  • 92201 CMS LCD: Billing and Coding: Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy and Fundus Photography) CMS LCD
  • 92202 CMS LCD: Billing and Coding: Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy and Fundus Photography) CMS LCD
  • 92250 CMS LCD: Billing and Coding: Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy and Fundus Photography) CMS LCD
  • 92227 CMS LCD: Billing and Coding: Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy and Fundus Photography) CMS LCD
  • C8931 CMS LCD: Billing and Coding: Magnetic Resonance Angiography CMS LCD
  • C8936 CMS LCD: Billing and Coding: Magnetic Resonance Angiography CMS LCD
  • C8934 CMS LCD: Billing and Coding: Magnetic Resonance Angiography CMS LCD
  • C8932 CMS LCD: Billing and Coding: Magnetic Resonance Angiography CMS LCD
  • C8935 CMS LCD: Billing and Coding: Magnetic Resonance Angiography CMS LCD

Convert D49.81 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
D49.81 23981 00000

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

ICD-10 D49.81, Billing FAQ

Is ICD-10 code D49.81 billable? +

Yes, D49.81 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 D49.81? +

ICD-10 D49.81 includes: Dark area on retina; Retinal freckle.

What CPT codes are commonly billed with D49.81? +

Procedures frequently paired with D49.81 include: 92228, 92201, 92202, 92250, 92227.

What ICD-9 codes does D49.81 map to? +

Per CMS GEMs, D49.81 maps to ICD-9 codes: 23981. 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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