C49.20 — Malignant neoplasm of connective and soft tissue of unspecified lower limb, including hip
Is C49.20 billable?
Yes, but C49.20 is an unspecified code. C49.20 is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, C49.20 is an unspecified or catch-all code. Payers apply additional scrutiny to unspecified codes and many deny them when the medical record supports a more specific option, so check the documentation before selecting C49.20 — the more specific alternatives are listed below.
C49.20 at a glance
| Code | C49.20 |
|---|---|
| Description | Malignant neoplasm of connective and soft tissue of unspecified lower limb, including hip |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
Which MS-DRGs does C49.20 group to?
C49.20 sits in MDC 08 and helps define the logic of 3 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 542Pathological Fractures and Musculoskeletal and Connective Tissue Malignancy with MCCmedical
- 543Pathological Fractures and Musculoskeletal and Connective Tissue Malignancy with CCmedical
- 544Pathological Fractures and Musculoskeletal and Connective Tissue Malignancy without CC/MCCmedical
As a secondary diagnosis, C49.20 is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG.
Excludes1 — never code together — inherited from C49
The conditions below can never be reported together with C49.20 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
Excludes2 — not included here — inherited from C49
The conditions below are not part of C49.20, but a patient may have both at the same time. When documentation supports it, C49.20 and the excluded code may both be reported.
- Kaposi's sarcoma of soft tissue (C46.1)
- malignant neoplasm of heart (C38.0)
- malignant neoplasm of peripheral nerves and autonomic nervous system (C47.-)
- malignant neoplasm of peritoneum (C48.2)
- malignant neoplasm of retroperitoneum (C48.0)
- malignant neoplasm of uterine ligament (C57.3)
- mesothelioma (C45.-)
How long has C49.20 existed?
C49.20 has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.