ICD-10 · PDGM grouping
D49 Neoplasms of unspecified behavior
All 14 codes in the D49 family, with the PDGM clinical group, comorbidity subgroup and primary-position rule CMS assigns, read from the CMS grouper crosswalk v07.2.26 and the CDC FY2027 code file.
Codes in family
14
Can lead a claim
12
Cannot lead a claim
2
What CMS assigns to D49
12 of the 14 codes group to MMTA - Infectious Disease, Neoplasms, and Blood-Forming Diseases (10) and Neuro Rehabilitation (2); 2 are assigned no clinical group. None of the 14 is assigned a comorbidity subgroup. 12 of the 14 can lead a claim.
Every code in D49
Descriptions are CDC’s FY2027 wording; where CMS’s grouper abbreviates one, its form is shown beneath.
| Code | Description | Primary position | Clinical group | Comorbidity subgroup |
|---|---|---|---|---|
| D49.0 | Neoplasm of unspecified behavior of digestive system | Can lead a claim | K | None |
| D49.1 | Neoplasm of unspecified behavior of respiratory system | Can lead a claim | K | None |
| D49.2 | Neoplasm of unspecified behavior of bone, soft tissue, and skinCMS: Neoplasm of unsp behavior of bone, soft tissue, and skin | Can lead a claim | K | None |
| D49.3 | Neoplasm of unspecified behavior of breast | Can lead a claim | K | None |
| D49.4 | Neoplasm of unspecified behavior of bladder | Can lead a claim | K | None |
| D49.5 Neoplasm of unspecified behavior of other genitourinary organs | ||||
| D49.51 Neoplasm of unspecified behavior of kidney | ||||
| D49.511 | Neoplasm of unspecified behavior of right kidney | Can lead a claim | K | None |
| D49.512 | Neoplasm of unspecified behavior of left kidney | Can lead a claim | K | None |
| D49.519 | Neoplasm of unspecified behavior of unspecified kidney | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| D49.59 | Neoplasm of unspecified behavior of other genitourinary organCMS: Neoplasm of unspecified behavior of other GU organ | Can lead a claim | K | None |
| D49.6 | Neoplasm of unspecified behavior of brain | Can lead a claim | B | None |
| D49.7 | Neoplasm of unspecified behavior of endocrine glands and other parts of nervous systemCMS: Neoplm of unsp behav of endo glands and oth prt nervous sys | Can lead a claim | K | None |
| D49.8 Neoplasm of unspecified behavior of other specified sites | ||||
| D49.81 | Neoplasm of unspecified behavior of retina and choroid | Can lead a claim | B | None |
| D49.89 | Neoplasm of unspecified behavior of other specified sites | Can lead a claim | K | None |
| D49.9 | Neoplasm of unspecified behavior of unspecified site | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
Sources: CMS HH PPS Grouper Software v07.2.26, effective 2026-10-01, for the clinical group, comorbidity subgroup, code-first conventions and primary-position flags; CDC NCHS ICD-10-CM FY2027 code descriptions for the family title and code wording. This is the crosswalk Medicare runs a claim through. Grouping also depends on admission source, timing, the OASIS functional items and the rest of the diagnosis list.
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