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ICD-10 Guide
ICD-10 CodesD13.7

D13.7

Billable

Benign neoplasm of endocrine pancreas

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 D13.7 is a billable code used to indicate a diagnosis of benign neoplasm of endocrine pancreas.

Key Diagnostic Point:

Benign neoplasms of the endocrine pancreas, such as insulinomas and gastrinomas, are rare tumors that arise from the hormone-producing cells of the pancreas. These tumors are typically well-circumscribed and can be asymptomatic or cause symptoms related to hormone overproduction. Insulinomas, for example, can lead to hypoglycemia due to excessive insulin secretion, while gastrinomas can cause Zollinger-Ellison syndrome, characterized by recurrent peptic ulcers. Diagnosis often involves imaging studies such as CT scans or MRIs, along with biochemical tests to assess hormone levels. Although benign, these neoplasms require careful monitoring due to their potential for local invasion or, in rare cases, malignant transformation. Regular follow-up with imaging and clinical evaluation is essential to ensure that any changes in size or behavior are promptly addressed.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiation between benign and malignant neoplasms
  • Need for precise documentation of tumor type and behavior
  • Variability in clinical presentation and symptoms
  • Potential for associated conditions requiring additional coding

Audit Risk Factors

  • Inadequate documentation of tumor type
  • Failure to report associated symptoms or complications
  • Lack of follow-up documentation
  • Misclassification of benign neoplasm as malignant

Specialty Focus

Medical Specialties

Endocrinology

Documentation Requirements

Detailed hormonal assay results and imaging studies.

Common Clinical Scenarios

Patients presenting with hypoglycemia or recurrent ulcers.

Billing Considerations

Ensure accurate documentation of hormone levels and any surgical interventions.

Surgery

Documentation Requirements

Operative reports detailing tumor excision and pathology results.

Common Clinical Scenarios

Surgical removal of insulinomas or gastrinomas.

Billing Considerations

Document the extent of resection and any complications during surgery.

Coding Guidelines

Inclusion Criteria

Use D13.7 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the neoplasm's behavior and any associated conditions
  • Include relevant imaging and laboratory results to support the diagnosis

Exclusion Criteria

Do NOT use D13.7 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

49320CPT Code

Laparoscopic exploration of the abdomen

Clinical Scenario

Used when a patient with a suspected pancreatic neoplasm undergoes laparoscopic evaluation.

Documentation Requirements

Operative report detailing findings and any interventions.

Specialty Considerations

Ensure that the surgical specialty documents the nature of the neoplasm.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of benign neoplasms, improving the accuracy of data collection and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of benign neoplasms, improving the accuracy of data collection and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

Resources

Clinical References

  • •
    American Cancer Society - Pancreatic Cancer

Coding & Billing References

  • •
    American Cancer Society - Pancreatic Cancer

Frequently Asked Questions

What are the common symptoms of a benign neoplasm of the endocrine pancreas?

Common symptoms include hypoglycemia, abdominal pain, and symptoms related to excessive hormone production, such as peptic ulcers in the case of gastrinomas.