Benign neoplasms, except benign neuroendocrine tumors

Historical Changes

• •FY 2025: Routine maintenance updates with minor terminology clarifications
• •FY 2024: Enhanced specificity requirements for certain code ranges
• •FY 2023: Updated documentation guidelines for improved clarity

Upcoming Changes

• •Proposed updates pending review by Coordination and Maintenance Committee
• •Under consideration: Enhanced digital health integration codes

Implementation Guidance

• •Review all FY 2026 updates for D10-D36 codes before implementation
• •Always verify the most current codes in the ICD-10-CM manual
• •Ensure clinical documentation supports the selected diagnosis codes
• +3 more guidance items...

Key Usage Points:

• •D10-D36 codes are used for benign tumors, not for malignant or unspecified tumors.
• •The codes specify the location of the tumor, not its size or number.
• •Some codes in this range require additional codes to identify any associated conditions.
• •The fourth character in the code usually indicates the specific location of the tumor.
• •Use additional codes to identify any functional activity.

When to Use:

• ✓When a patient has a diagnosed benign neoplasm.
• ✓When a benign neoplasm is discovered during a procedure.
• ✓When a patient has a history of benign neoplasm.
• ✓When a benign neoplasm is causing symptoms or complications.

When NOT to Use:

• ✗When the neoplasm is malignant or unspecified.
• ✗When the neoplasm is a benign neuroendocrine tumor.
• ✗When the neoplasm is located in an organ or tissue not covered by this range.
• ✗When the neoplasm is a cyst or polyp, unless specified as a neoplasm by the provider.

Common Documentation Errors:

• ⚠Not specifying the location of the neoplasm
• ⚠Not documenting associated conditions or complications
• ⚠Not including supporting evidence
• ⚠Using an unspecified code when specific information is available