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D36.9 ICD-10-CM Code: Benign neoplasm, unspecified site

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Inpatient Payment Groups (MS-DRG)

Potential MS-DRG participation — not a DRG assignment.

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43, Appendix B.

  • MS-DRG 826 — MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH MCC (MDC 17)
  • MS-DRG 827 — MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH CC (MDC 17)
  • MS-DRG 828 — MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC (MDC 17)
  • MS-DRG 829 — MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITH CC/MCC (MDC 17)
  • MS-DRG 830 — MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITHOUT CC/MCC (MDC 17)
  • MS-DRG 843 — OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH MCC (MDC 17)
  • MS-DRG 844 — OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH CC (MDC 17)
  • MS-DRG 845 — OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITHOUT CC/MCC (MDC 17)

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.

Coder workflow for D36.9

MedCoder structured workflow — derived from this code’s own official record

Before you code D36.9

  1. Unspecified does not mean incorrect. When the record gives no greater specificity, D36.9 may be the appropriate code. Check the record for detail that supports a more specific sibling. An unspecified code is for records that do not provide the detail a more specific code needs; a query, not an assumption, is the route to specificity (Guidelines I.A.9.b, I.B.18).

    ReviewD36.0, D36.1, D36.7

    See the relationships section · Guide: Other vs unspecified (NEC vs NOS) →

  2. Confirm the documented site and behavior (this code’s block classifies benign neoplasms), whether the site is primary or secondary, and whether the malignancy is current or a personal history: a previously excised malignancy with no further treatment and no evidence of disease is history, not current disease. Verify the site against the Table of Neoplasms. Neoplasm chapter guidelines (Guidelines I.C.2.a, I.C.2.d, I.C.2.m).

    See the Table of Neoplasms entries · Guide: Active cancer vs history of cancer →

Choose the right path

  1. Does the record document the detail a more specific sibling code needs?
    Yes → Review the specific siblings in this subcategory.
    No → Continue — D36.9 is appropriate when the documentation goes no further.

    ReviewD36.0, D36.1, D36.7

Consider D36.9. Then confirm the code is valid for the date of service in the Verify section.

Documentation check

The provider’s diagnostic statement
Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
Anatomical site
At the most specific level the record states; a site the classification separates cannot be assumed from a procedure or a measurement.
Behavior and current-versus-history status
Malignant, in situ, benign or uncertain; primary or secondary; current disease or personal history (Guidelines I.C.2.m).
Any detail beyond this code’s title
What the record states that a more specific sibling code would capture — or its absence, which itself supports the unspecified code.

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Documentation: The provider documents the condition in the terms of this code’s title and records no further detail.

Coding question: Is a more specific sibling code supportable?

Path: Review the specific siblings in this subcategory and what each requires the record to state.

Reason: A more specific code needs documentation of the distinguishing element; without it the unspecified code is appropriate, and a provider query is the route to specificity (Guidelines I.A.9.b, I.B.18).

ReviewD36.0, D36.1, D36.7

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Code Overview

Benign neoplasm, unspecified site is a billable ICD-10-CM diagnosis code (D36.9).

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Indexed Clinical Terms (1)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

Neoplasm Table Sites (2)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Anatomical sites from the official ICD-10-CM Table of Neoplasms that map to this code, with the matching behavior column.

  • Neoplasm, neoplastic — Benign
  • Neoplasm, neoplastic, unknown site or unspecified — Benign

Verify Before Coding

  • No Medicare Code Editor or MS-DRG Definitions Manual restrictions apply to this code.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder structured relationships — computed from published CMS and AHRQ datasets

Other codes that name D36.9 or its code family, from the CMS Table of Neoplasms and the CMS Table of Neoplasms (site match derived from the code title).

Referenced by 5 Same-site neoplasm codes: C79.9 — Secondary malignant neoplasm of unspecified siteCompare D36.9 vs C79.9 →, C80.1 — Malignant (primary) neoplasm, unspecifiedCompare D36.9 vs C80.1 →, D09.9 — Carcinoma in situ, unspecifiedCompare D36.9 vs D09.9 →, D48.9 — Neoplasm of uncertain behavior, unspecifiedCompare D36.9 vs D48.9 →, D49.9 — Neoplasm of unspecified behavior of unspecified siteCompare D36.9 vs D49.9 →.

These codes represent related neoplasm behaviors affecting the same anatomic site.

Referenced by 1 Screening & history code: Z85.819 — Personal history of malignant neoplasm of unspecified site of lip, oral cavity, and pharynxCompare D36.9 vs Z85.819 →.

These codes represent screening tests and history codes that refer to this active disease condition.

MS-DRG Grouper Relationships (FY2026)

Potential MS-DRG participation — not a DRG assignment.

FY2026 MS-DRG: not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity for that release.

Named in the grouper logic of 8 MS-DRGs: DRG 826 (MDC 17), DRG 827 (MDC 17), DRG 828 (MDC 17), DRG 829 (MDC 17), DRG 830 (MDC 17), DRG 843 (MDC 17), DRG 844 (MDC 17), DRG 845 (MDC 17).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):NEO073 — Benign neoplasms (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Benign neoplasms).

D36.0 — Benign neoplasm of lymph nodes, D36.10 — Benign neoplasm of peripheral nerves and autonomic nervous system, unspecified, D36.11 — Benign neoplasm of peripheral nerves and autonomic nervous system of face, head, and neck, D36.12 — Benign neoplasm of peripheral nerves and autonomic nervous system, upper limb, including shoulder, D36.13 — Benign neoplasm of peripheral nerves and autonomic nervous system of lower limb, including hip, D36.14 — Benign neoplasm of peripheral nerves and autonomic nervous system of thorax, D36.15 — Benign neoplasm of peripheral nerves and autonomic nervous system of abdomen, D36.16 — Benign neoplasm of peripheral nerves and autonomic nervous system of pelvis, D36.17 — Benign neoplasm of peripheral nerves and autonomic nervous system of trunk, unspecified, D36.7 — Benign neoplasm of other specified sites, D3A.00 — Benign carcinoid tumor of unspecified site, D3A.010 — Benign carcinoid tumor of the duodenum, D3A.011 — Benign carcinoid tumor of the jejunum, D3A.012 — Benign carcinoid tumor of the ileum, D3A.019 — Benign carcinoid tumor of the small intestine, unspecified portion, D3A.020 — Benign carcinoid tumor of the appendix, D3A.021 — Benign carcinoid tumor of the cecum, D3A.022 — Benign carcinoid tumor of the ascending colon, D3A.023 — Benign carcinoid tumor of the transverse colon, D3A.024 — Benign carcinoid tumor of the descending colon, +252 more

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main term “Polyposis”; these codes share that main term but sit in a different category of the Tabular List.

C18.9 — Malignant neoplasm of colon, unspecified (coli, carcinoma in), C83.1 — Mantle cell lymphoma (malignant lymphomatous), D12.6 — Benign neoplasm of colon, unspecified (coli), D13.91 — Familial adenomatous polyposis (familial, adenomatous)

Lab tests where this diagnosis supports Medicare coverage (NCD)

Medicare's National Coverage Determination (NCD) program lists this diagnosis as medical justification for these lab tests.

Iron Panel

Contextual Map

Every relationship of D36.9 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

Same site

Referenced by Same-site neoplasm codes

Referenced by Screening & history codes MedCoder-derived

Clinical classification (CCSR)

MS-DRG Grouper

MDC crossing

  • MDC 17 — Myeloproliferative Diseases and Disorders, Poorly Differentiated Neoplasms[MDC crossing]: “Myeloproliferative Diseases and Disorders, Poorly Differentiated Neoplasms — 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. 4,730 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2026

Neoplasm sites

  • Neoplasm, neoplastic — Neoplasm, neoplastic — Benign [Neoplasm table]: “Neoplasm, neoplastic (Benign)”— CMS Table of Neoplasms · icd10cm-fy2026
  • Neoplasm, neoplastic, unknown site or unspecified — Neoplasm, neoplastic, unknown site or unspecified — Benign [Neoplasm table]: “Neoplasm, neoplastic, unknown site or unspecified (Benign)”— CMS Table of Neoplasms · icd10cm-fy2026

Index entries

  • Polyposis, multiple, adenomatous[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026

Nearest codes (12)

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data
CMS/CDC ICD-10-CM FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page
Inpatient payment groups Official source data
CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v43 Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data
CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder structured relationship
Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder explanation
Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "D36.9 — Benign neoplasm, unspecified site." ICD-10-CM FY2026. https://medcoder.ai/icd10/code/d36.9-benign-neoplasm-unspecified-site

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Benign neoplasm, unspecified site

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027 (effective October 1, 2026), and none are recorded for this code. Note changes are tracked from FY2027 only.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to D36.9 in its code family, with their registry titles.

View all codes in the D36 family