Neoplasm of uncertain behavior of brain and spinal cord

This code signifies a tumor originating in the brain or spinal cord where the pathologist cannot definitively classify it as benign or malignant. These neoplasms exhibit features that are not clearly benign but also lack the unequivocal characteristics of malignancy, requiring further observation or diagnostic workup.

Use this code when pathology reports indicate a brain or spinal cord tumor as "uncertain behavior," "borderline malignancy," or "of undetermined malignant potential." Documentation must explicitly state the uncertain nature of the neoplasm, often following an initial biopsy or resection.

• Do not use this code if the pathology definitively states benign or malignant; instead, use the appropriate benign or malignant neoplasm code.
• Always review the final pathology report. If subsequent pathology clarifies the tumor as benign or malignant, update the diagnosis accordingly.
• This code often requires sequencing as a primary diagnosis when the uncertain nature of the tumor is the focus of the encounter.