D43.4
BillableNeoplasm of uncertain behavior of spinal cord
HCC Category Mapping
V28HCC 23 — Melanoma and Other Skin Cancers
0.251V24HCC 12 — Breast, Prostate, and Other Cancers and Tumors
0.150ESRDHCC 12 — Breast, Prostate, and Other Cancers and Tumors
0.000RxHCCHCC 22 — Cancer, Other Specified Sites
0.000What This Code Means
A tumor of the spinal cord that has uncertain behavior and cannot yet be definitively classified as benign or malignant.
Coding Tips
- •Document the specific location within the spinal cord if available (cervical, thoracic, lumbar, sacral)
- •Coordinate with pathology report to confirm uncertain behavior classification
Clinical Significance
Neoplasms of uncertain behavior of the spinal cord include tumors such as ependymomas and astrocytomas with atypical features that preclude definitive benign or malignant classification. These tumors can cause progressive neurological deficits including weakness, sensory changes, and bowel or bladder dysfunction depending on the spinal level involved.
Documentation Requirements
- ✓Documentation must confirm the tumor is within the spinal cord (intramedullary) rather than the spinal meninges (D42.1) or extraspinal structures.
- ✓The spinal level (cervical, thoracic, lumbar, sacral) should be specified.
- ✓Pathology should describe features supporting uncertain behavior classification, and neurological examination findings should be recorded.
Commonly Confused Codes
D42.1 (uncertain behavior of spinal meninges) involves the meninges covering the spinal cord, not the cord itself.D33.4 (benign neoplasm of spinal cord) is used for confirmed benign tumors.C72.0 (malignant neoplasm of spinal cord) is the malignant counterpart.D43.8 (other specified parts of central nervous system) covers other central nervous system locations.
Code Hierarchy
└D43Neoplasm of uncertain behavior of brain and central nervous system└D43.4Neoplasm of uncertain behavior of spinal cord
└D43.4Neoplasm of uncertain behavior of spinal cord