D49.4

Documentation support

General coding-documentation guidance — not a substitute for payer-specific requirements or professional coding judgment.

• •As a general rule, code to the highest level of specificity supported by the documentation in the medical record.

ICD-9-CM equivalent

Informational only — GEM mappings are approximate, not guaranteed one-to-one equivalents. Verify before use in billing.

• 2394

Associated MS-DRGs

D49.4 can serve as the principal diagnosis for these Medicare Severity Diagnosis-Related Groups.

Informational only — actual DRG assignment also depends on procedures, complications/comorbidities (CC/MCC), discharge status, and payer-specific rules not reflected here.

• DRG 643Endocrine Disorders with MCC
• DRG 644Endocrine Disorders with CC
• DRG 645Endocrine Disorders without CC/MCC
• DRG 656Kidney and Ureter Procedures for Neoplasm with MCC
• DRG 657Kidney and Ureter Procedures for Neoplasm with CC
• DRG 658Kidney and Ureter Procedures for Neoplasm without CC/MCC
• DRG 659Kidney and Ureter Procedures for Non-Neoplasm with MCC
• DRG 660Kidney and Ureter Procedures for Non-Neoplasm with CC
• DRG 661Kidney and Ureter Procedures for Non-Neoplasm without CC/MCC
• DRG 686Kidney and Urinary Tract Neoplasms with MCC
• DRG 687Kidney and Urinary Tract Neoplasms with CC
• DRG 688Kidney and Urinary Tract Neoplasms without CC/MCC