C49.A1

Gastrointestinal stromal tumor of esophagus

FY2027Chapter 2: Neoplasms/C45–C49 Malignant neoplasms of mesothelial and soft tissue

BillableComplete code, valid to report

C49.A1 (also written C49A1) is a billable ICD-10-CM diagnosis code for gastrointestinal stromal tumor of esophagus. It is part of the FY2027 code set, effective October 1, 2026. It is one of the 20 codes in category C49 (Malignant neoplasm of other connective and soft tissue). The Alphabetic Index lists it under 2 entries. Its coding notes include 5 Excludes1 entries and 7 Excludes2 entries.

Guidelines tip

From the FY2027 Official Guidelines. ICD10Ref adds no rules of its own.

A primary malignancy code stays in use until treatment directed at that site is completed. After that, with no evidence of disease at the site, Z85 gives the former site.

Guidelines I.C.2.mCurrent malignancy versus personal history of malignancyRead the official text

Excludes1

Not coded here. The listed conditions generally should not be reported together.

Inherited from C49 Malignant neoplasm of other connective and soft tissue
  • malignant neoplasm of cartilage (of):

Excludes2

Not included here. Both codes may be reported if the patient has both conditions.

Inherited from C49 Malignant neoplasm of other connective and soft tissue
  • 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.-)

Care settings

How CMS programs treat this code. These are CMS claim edits and list entries, not coverage or eligibility rules.

Home Health Primary

Accepted as the primary (principal) diagnosis on a home health claim. The Home Health Grouper assigns it to the MMTA - Infectious Disease, Neoplasms, and Blood-Forming Diseases clinical group.

Source: CMS Home Health Grouper Software v07.2.26, effective October 1, 2026

Hospital CC

Counts as a complication or comorbidity (CC) when reported as a secondary diagnosis on an inpatient claim. It does not count when the principal diagnosis is one of the 2 codes in its exclusion list. Some MS-DRGs also ignore a CC or MCC that defines the DRG.

Source: CMS MS-DRG Definitions Manual v44, effective October 1, 2026, Appendix C

IPF Comorbidity

On the CMS IPF comorbidity list.

Comorbidity categoryFactor
Oncology Treatment1.44
It counts as a comorbidity when reported as a secondary diagnosis and actively treated during the stay. An IPF receives only one adjustment within a category and can receive adjustments in more than one category.

Source: CMS IPF PPS FY 2027 final rule (CMS-1847-F), Addendum B-3 (comorbidity codes with adjustment factor); effective for discharges on or after October 1, 2026

Includes

Further defines or gives examples of the content of the category.

Inherited from C49 Malignant neoplasm of other connective and soft tissue
  • malignant neoplasm of blood vessel
  • malignant neoplasm of bursa
  • malignant neoplasm of cartilage
  • malignant neoplasm of fascia
  • malignant neoplasm of fat
  • malignant neoplasm of ligament, except uterine
  • malignant neoplasm of lymphatic vessel
  • malignant neoplasm of muscle
  • malignant neoplasm of synovia
  • malignant neoplasm of tendon (sheath)

Notes

Also from chapter/block level (8 notes)
Inherited from Chapter 2 Neoplasms
  • Functional activity
  • All neoplasms are classified in this chapter, whether they are functionally active or not. An additional code from Chapter 4 may be used, to identify functional activity associated with any neoplasm.
  • Morphology [Histology]
  • Chapter 2 classifies neoplasms primarily by site (topography), with broad groupings for behavior, malignant, in situ, benign, etc. The Table of Neoplasms should be used to identify the correct topography code. In a few cases, such as for malignant melanoma and certain neuroendocrine tumors, the morphology (histologic type) is included in the category and codes.
  • Primary malignant neoplasms overlapping site boundaries
  • A primary malignant neoplasm that overlaps two or more contiguous (next to each other) sites should be classified to the subcategory/code .8 ('overlapping lesion'), unless the combination is specifically indexed elsewhere. For multiple neoplasms of the same site that are not contiguous, such as tumors in different quadrants of the same breast, codes for each site should be assigned.
  • Malignant neoplasm of ectopic tissue
  • Malignant neoplasms of ectopic tissue are to be coded to the site mentioned, e.g., ectopic pancreatic malignant neoplasms are coded to pancreas, unspecified (C25.9).

Alphabetic Index terms

Terms the official Alphabetic Index lists for this code. 2 entries