D37.0 vs D48.5
D37.0 (Neoplasm of uncertain behavior of lip, oral cavity and pharynx) compared with D48.5 (Neoplasm of uncertain behavior of skin), 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. D37.0 carries an Excludes1 note covering D48.5: “neoplasm of uncertain behavior of skin of lip (D48.5)”
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. D48.5 carries an Excludes1 note covering D37.0: “neoplasm of uncertain behavior of vermilion border of lip (D37.0)”
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
| D37.0Neoplasm of uncertain behavior of lip, oral cavity and pharynx | D48.5Neoplasm of uncertain behavior of skin | |
|---|---|---|
| Billing status | Non-billable header | Billable |
| Classification | C00-D49 — Neoplasms (C00-D49) | C00-D49 — Neoplasms (C00-D49) |
| Definition | Neoplasm of uncertain behavior of lip, oral cavity and pharynx is a non-billable ICD-10-CM category code (D37.0). | Neoplasm of uncertain behavior of skin is a billable ICD-10-CM diagnosis code (D48.5). |
| Includes | — | 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 |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources