D38.5 vs D49.1

D38.5 (Neoplasm of uncertain behavior of other respiratory organs) compared with D49.1 (Neoplasm of unspecified behavior of respiratory system), from the official CMS tabular data. Do not report these codes together: the official tabular list marks them Excludes1.

Relationship

Conflict

Excludes1 conflict

D38.5

Neoplasm of uncertain behavior of other respiratory organs

↔

D49.1

Neoplasm of unspecified behavior of respiratory system

Not coded here — these two are mutually exclusive.

“neoplasms of unspecified behavior (D49.-)”

An Excludes1 note means the two conditions cannot occur together, so the pair should not be reported for the same encounter. The sole exception is when the conditions are documented as unrelated to each other.

Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a

Informational

Excludes2 relationship

D49.1

Neoplasm of unspecified behavior of respiratory system

↔

D38.5

Neoplasm of uncertain behavior of other respiratory organs

Distinct conditions — both may be reported.

“neoplasms of uncertain behavior (D37-D44, D48)”

An Excludes2 note means the excluded condition is not part of the code above it, but a patient can have both. Report both when both are documented.

Source: CMS ICD-10-CM tabular instructional notes

Can these codes be reported together?

No — do not report together. D38.5 carries an Excludes1 note covering D49.1: “neoplasms of unspecified behavior (D49.-)”

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

Yes, when both are documented. D49.1 carries an Excludes2 note covering D38.5: “neoplasms of uncertain behavior (D37-D44, D48)”

Excludes2 marks distinct conditions — both may be reported when both are documented.

Side by side

	D38.5Neoplasm of uncertain behavior of other respiratory organs	D49.1Neoplasm of unspecified behavior of respiratory system
Billing status	Billable	Billable
Classification	C00-D49 — Neoplasms (C00-D49)	C00-D49 — Neoplasms (C00-D49)
Definition	Neoplasm of uncertain behavior of other respiratory organs is a billable ICD-10-CM diagnosis code (D38.5).	Neoplasm of unspecified behavior of respiratory system is a billable ICD-10-CM diagnosis code (D49.1).
Includes	Neoplasm of uncertain behavior of accessory sinuses Neoplasm of uncertain behavior of cartilage of nose Neoplasm of uncertain behavior of middle ear Neoplasm of uncertain behavior of nasal cavities	'growth' NOS neoplasm NOS new growth NOS tumor NOS

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