C49.A1 ICD-10-CM Code: Gastrointestinal stromal tumor of esophagus
Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.
Inpatient Payment Groups (MS-DRG)
MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43.0, Appendix B.
- MS-DRG 374 — DIGESTIVE MALIGNANCY WITH MCC (MDC 06)
- MS-DRG 375 — DIGESTIVE MALIGNANCY WITH CC (MDC 06)
- MS-DRG 376 — DIGESTIVE MALIGNANCY WITHOUT CC/MCC (MDC 06)
A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.
Risk Adjustment (CMS-HCC)
Payment categories this diagnosis maps to under CMS-HCC V28, payment year 2026.
- HCC 23 — Prostate, Breast, and Other Cancers and Tumors
Other models: CMS-HCC V22 HCC 10 · RxHCC V08 HCC 20
Risk scores depend on the enrollee's full accepted diagnosis set and segment; a category mapping alone does not determine payment.
Official Registry Overview & Definition
Official Tabular Instructional Notes
Sequencing, inclusion, and exclusion notes published for C49.A1 in the official ICD-10-CM tabular list.
Includes
Conditions the official ICD-10-CM tabular list includes under this code.
- malignant neoplasm of blood vessel
- malignant neoplasm of bursa
- malignant neoplasm of cartilage
- malignant neoplasm of fascia
- malignant neoplasm of fat
- malignant neoplasm of ligament, except uterine
- malignant neoplasm of lymphatic vessel
- malignant neoplasm of muscle
- malignant neoplasm of synovia
- malignant neoplasm of tendon (sheath)
Excludes1 — Not Coded Here
Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).
- malignant neoplasm of cartilage (of):
- articular (C40-C41) Compare C49.A1 vs C40 →
- larynx (C32.3) Compare C49.A1 vs C32.3 →
- nose (C30.0) Compare C49.A1 vs C30.0 →
- malignant neoplasm of connective tissue of breast (C50.-) Compare C49.A1 vs C50 →
Excludes2 — Not Included Here
Conditions not covered by this code, but which may be reported alongside it when both are present.
- Kaposi's sarcoma of soft tissue (C46.1) Compare C49.A1 vs C46.1 →
- malignant neoplasm of heart (C38.0) Compare C49.A1 vs C38.0 →
- malignant neoplasm of peripheral nerves and autonomic nervous system (C47.-) Compare C49.A1 vs C47 →
- malignant neoplasm of peritoneum (C48.2) Compare C49.A1 vs C48.2 →
- malignant neoplasm of retroperitoneum (C48.0) Compare C49.A1 vs C48.0 →
- malignant neoplasm of uterine ligament (C57.3) Compare C49.A1 vs C57.3 →
- mesothelioma (C45.-) Compare C49.A1 vs C45 →
Indexed Clinical Terms (2)
Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code.
- Tumor, stromal, gastrointestinal, esophagus
- Tumor, stromal, gastrointestinal, malignant, esophagus
Frequently Compared Codes
The official Excludes notes on C49.A1 name these codes. Each comparison page covers when the two can — or must not — be reported together.
Change history
- FY2017 — 2016-10-01Added to the code setGastrointestinal stromal tumor of esophagusFY2017 changes
Verify Before Coding
- CC as a secondary diagnosis (FY2026). Can raise the stay's MS-DRG severity tier.
From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim.
Relationships & Classification
Official ICD-10-CM tabular notes on other codes that name C49.A1 or its code family.
3 Excludes1 notes: C40 (via C49.-), C40-C41 (via C49.-), C41 (via C49.-).
13 Excludes2 notes: C15 (via C49.A.-), C15-C26 (via C49.A.-), C16 (via C49.A.-), C17 (via C49.A.-), C18 (via C49.A.-), C19 (via C49.A.-), C20 (via C49.A.-), C21 (via C49.A.-), C22 (via C49.A.-), C23 (via C49.A.-) and 3 more.
1 Code First instructions: M63 (via C49.-).
Potential MS-DRG Relationships (FY2026)
CC — Complication or Comorbidity. Reported as a secondary diagnosis, this code raises the stay's MS-DRG severity tier — except when the principal diagnosis is one of 2 clinically related codes on its CMS exclusion list.
Named in the grouper logic of 3 MS-DRGs: DRG 374 (MDC 06), DRG 375 (MDC 06), DRG 376 (MDC 06).
From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.
Clinical classification (AHRQ CCSR):NEO012 — Gastrointestinal cancers - esophagus (default).
Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.
Contextual Map
Every relationship of C49.A1 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.
Hierarchy
- C00-D49 — Chapter 2: Neoplasms (C00-D49) (C00-D49) [Hierarchy]
- C00-C75 — Malignant neoplasms, stated or presumed to be primary (of specified sites), and certain specified histologies, except neuroendocrine, and of lymphoid, hematopoietic and related tissue [Hierarchy]
Referenced by Excludes1 notes
- C40 — Malignant neoplasm of bone and articular cartilage of limbs [Excludes1](via C49.-): “malignant neoplasm of synovia (C49.-)” · check together
- C40-C41 — Malignant neoplasms of bone and articular cartilage (C40-C41) [Excludes1](via C49.-): “malignant neoplasm of synovia (C49.-)” · check together
- C41 — Malignant neoplasm of bone and articular cartilage of other and unspecified sites [Excludes1](via C49.-): “malignant neoplasm of synovia (C49.-)” · check together
Referenced by Excludes2 notes (13)
- C15 — Malignant neoplasm of esophagus [Excludes2](via C49.A.-): “gastrointestinal stromal tumors (C49.A-)” · check together
- C15-C26 — Malignant neoplasms of digestive organs (C15-C26) [Excludes2](via C49.A.-): “gastrointestinal stromal tumors (C49.A-)” · check together
- C16 — Malignant neoplasm of stomach [Excludes2](via C49.A.-): “gastrointestinal stromal tumors (C49.A-)” · check together
- C17 — Malignant neoplasm of small intestine [Excludes2](via C49.A.-): “gastrointestinal stromal tumors (C49.A-)” · check together
- C18 — Malignant neoplasm of colon [Excludes2](via C49.A.-): “gastrointestinal stromal tumors (C49.A-)” · check together
- C19 — Malignant neoplasm of rectosigmoid junction [Excludes2](via C49.A.-): “gastrointestinal stromal tumors (C49.A-)” · check together
- C20 — Malignant neoplasm of rectum [Excludes2](via C49.A.-): “gastrointestinal stromal tumors (C49.A-)” · check together
- C21 — Malignant neoplasm of anus and anal canal [Excludes2](via C49.A.-): “gastrointestinal stromal tumors (C49.A-)” · check together
- and 5 more
Referenced by Code First instructions
- M63 — Disorders of muscle in diseases classified elsewhere [Code First](via C49.-): “neoplasm (C49.-, C79.89, D21.-, D48.1-)” · check together
Clinical classification (CCSR)
- NEO012 — Gastrointestinal cancers - esophagus [CCSR]
Risk adjustment (CMS-HCC)
- HCC 23 — Prostate, Breast, and Other Cancers and Tumors [CMS-HCC]
Potential MS-DRG
- CC — Complication or Comorbidity [MS-DRG severity]: “As a secondary diagnosis this code can raise the stay's MS-DRG severity tier (CC).”
- DRG 374 — DIGESTIVE MALIGNANCY WITH MCC [MS-DRG]: “DIGESTIVE MALIGNANCY WITH MCC (MDC 06)”
- DRG 375 — DIGESTIVE MALIGNANCY WITH CC [MS-DRG]: “DIGESTIVE MALIGNANCY WITH CC (MDC 06)”
- DRG 376 — DIGESTIVE MALIGNANCY WITHOUT CC/MCC [MS-DRG]: “DIGESTIVE MALIGNANCY WITHOUT CC/MCC (MDC 06)”
MDC crossing · procedures (5744)
- MDC 06 — Diseases and Disorders of the Digestive System [MDC crossing]: “Diseases and Disorders of the Digestive System — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs.”
- 008Q0ZZ — Division of Vagus Nerve, Open Approach [Same-MDC procedure]: “Division of Vagus Nerve, Open Approach — grouped in MDC 06, the procedure side of this code's crossing.” · check together
- 008Q3ZZ — Division of Vagus Nerve, Percutaneous Approach [Same-MDC procedure]: “Division of Vagus Nerve, Percutaneous Approach — grouped in MDC 06, the procedure side of this code's crossing.” · check together
- 008Q4ZZ — Division of Vagus Nerve, Percutaneous Endoscopic Approach [Same-MDC procedure]: “Division of Vagus Nerve, Percutaneous Endoscopic Approach — grouped in MDC 06, the procedure side of this code's crossing.” · check together
- 02BP3ZZ — Excision of Pulmonary Trunk, Percutaneous Approach [Same-MDC procedure]: “Excision of Pulmonary Trunk, Percutaneous Approach — grouped in MDC 06, the procedure side of this code's crossing.” · check together
- 02BQ3ZZ — Excision of Right Pulmonary Artery, Percutaneous Approach [Same-MDC procedure]: “Excision of Right Pulmonary Artery, Percutaneous Approach — grouped in MDC 06, the procedure side of this code's crossing.” · check together
- and 5739 more
Index entries
- Tumor, stromal, gastrointestinal, esophagus[Index term]
- Tumor, stromal, gastrointestinal, malignant, esophagus[Index term]
Nearest codes (23)
- C49 — Malignant neoplasm of other connective and soft tissue [Sibling]
- C49.0 — Malignant neoplasm of connective and soft tissue of head, face and neck [Sibling]
- C49.1 — Malignant neoplasm of connective and soft tissue of upper limb, including shoulder [Sibling]
- C49.10 — Malignant neoplasm of connective and soft tissue of unspecified upper limb, including shoulder [Sibling]
- C49.11 — Malignant neoplasm of connective and soft tissue of right upper limb, including shoulder [Sibling]
- C49.12 — Malignant neoplasm of connective and soft tissue of left upper limb, including shoulder [Sibling]
- C49.2 — Malignant neoplasm of connective and soft tissue of lower limb, including hip [Sibling]
- C49.20 — Malignant neoplasm of connective and soft tissue of unspecified lower limb, including hip [Sibling]
- and 15 more
Change history
- FY2017 — Added to the code set [Change history]
Nearest Codes in This Family
Official ICD-10-CM classifications closest to C49.A1 in its code family, with their registry titles.
- C49.6 — Malignant neoplasm of connective and soft tissue of trunk, unspecified
- C49.8 — Malignant neoplasm of overlapping sites of connective and soft tissue
- C49.9 — Malignant neoplasm of connective and soft tissue, unspecified
- C49.A — Gastrointestinal stromal tumor
- C49.A0 — Gastrointestinal stromal tumor, unspecified site
- C49.A2 — Gastrointestinal stromal tumor of stomach
- C49.A3 — Gastrointestinal stromal tumor of small intestine
- C49.A4 — Gastrointestinal stromal tumor of large intestine
- C49.A5 — Gastrointestinal stromal tumor of rectum
- C49.A9 — Gastrointestinal stromal tumor of other sites