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ICD-10 Guide
ICD-10 CodesD16.8

D16.8

Billable

Benign neoplasm of pelvic bones, sacrum and coccyx

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

Code Description

ICD-10 D16.8 is a billable code used to indicate a diagnosis of benign neoplasm of pelvic bones, sacrum and coccyx.

Key Diagnostic Point:

Benign neoplasms of the pelvic bones, sacrum, and coccyx are non-cancerous growths that can arise from various tissues in these areas. These neoplasms may include osteomas, chondromas, and other benign tumors that do not exhibit aggressive behavior or metastasize. Clinically, patients may present with localized pain, swelling, or discomfort, which can lead to imaging studies such as X-rays, CT scans, or MRIs for diagnosis. While benign, these neoplasms can sometimes cause complications, such as compression of adjacent structures or pathological fractures. Surveillance is often recommended to monitor for any changes in size or symptoms, as well as to ensure that the neoplasm remains benign. Although the malignant potential of these tumors is low, certain types may require surgical intervention if they cause significant symptoms or complications. Accurate diagnosis and coding are essential for appropriate management and follow-up care.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiation from malignant neoplasms
  • Variability in presentation and symptoms
  • Need for imaging studies for accurate diagnosis
  • Potential for surgical intervention

Audit Risk Factors

  • Inadequate documentation of benign nature
  • Failure to document surveillance plans
  • Misclassification as malignant
  • Lack of imaging results in the medical record

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed imaging reports, surgical notes if applicable, and follow-up plans.

Common Clinical Scenarios

Patients presenting with pelvic pain, incidental findings on imaging, or post-surgical follow-up.

Billing Considerations

Ensure clear documentation of the benign nature and any surgical interventions performed.

Radiology

Documentation Requirements

Comprehensive imaging reports detailing the characteristics of the neoplasm.

Common Clinical Scenarios

Imaging studies performed for pain evaluation or routine screenings revealing neoplasms.

Billing Considerations

Accurate description of the neoplasm's characteristics to support coding.

Coding Guidelines

Inclusion Criteria

Use D16.8 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the diagnosis is supported by clinical documentation
  • Include any relevant imaging studies and treatment plans in the medical record

Exclusion Criteria

Do NOT use D16.8 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

20610CPT Code

Arthrocentesis, aspiration and/or injection into a major joint or bursa

Clinical Scenario

Used when a patient with a benign neoplasm experiences joint pain.

Documentation Requirements

Document the reason for the procedure and the findings.

Specialty Considerations

Orthopedic specialists should ensure clear linkage between the procedure and the diagnosis.

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

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What is the significance of coding D16.8 accurately?

Accurate coding of D16.8 is crucial for proper patient management, ensuring appropriate follow-up and treatment plans, and for accurate reimbursement from payers.