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C40 vs C49.3

C40 (Malignant neoplasm of bone and articular cartilage of limbs) compared with C49.3 (Malignant neoplasm of connective and soft tissue of thorax), from the official CMS tabular data. Do not report these codes together: the official tabular list marks them Excludes1.

Can these codes be reported together?

No — do not report together. C40 carries an Excludes1 note covering C49.3: “malignant neoplasm of synovia (C49.-)”

Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

No — do not report together. C49.3 carries an Excludes1 note covering C40: “articular (C40-C41)”

Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Side by side

C40Malignant neoplasm of bone and articular cartilage of limbsC49.3Malignant neoplasm of connective and soft tissue of thorax
Billing statusNon-billable header

Report instead: C40.00, C40.01, C40.02, C40.10, C40.11

Billable
ClassificationC00-D49 — Neoplasms (C00-D49)C00-D49 — Neoplasms (C00-D49)
DefinitionMalignant neoplasm of bone and articular cartilage of limbs is a non-billable ICD-10-CM category code (C40).Malignant neoplasm of connective and soft tissue of thorax is a billable ICD-10-CM diagnosis code (C49.3).
Includes
malignant neoplasm of cartilage (articular) (joint)
malignant neoplasm of periosteum
malignant neoplasm of blood vessel
malignant neoplasm of bursa
malignant neoplasm of cartilage
malignant neoplasm of fascia
Use additional code
code to identify major osseous defect, if applicable (M89.7-)

Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources