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ICD-10 Guide
ICD-10 CodesD21.12

D21.12

Billable

Benign neoplasm of connective and other soft tissue of left upper limb, including shoulder

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

Code Description

ICD-10 D21.12 is a billable code used to indicate a diagnosis of benign neoplasm of connective and other soft tissue of left upper limb, including shoulder.

Key Diagnostic Point:

D21.12 refers to benign neoplasms that arise from connective and other soft tissues located in the left upper limb, which includes the shoulder region. These neoplasms can be composed of various tissue types, including fibrous tissue, adipose tissue, and vascular tissue. Common types of benign soft tissue tumors include lipomas, fibromas, and hemangiomas. Patients may present with a palpable mass, pain, or discomfort in the affected area, although many cases are asymptomatic and discovered incidentally during imaging studies. Diagnosis typically involves imaging techniques such as ultrasound or MRI, and histological examination may be necessary for definitive diagnosis. Management often includes observation for asymptomatic tumors, surgical excision for symptomatic or growing lesions, and regular follow-up to monitor for any changes. The prognosis for benign soft tissue neoplasms is generally excellent, with a low risk of recurrence following complete excision.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of benign neoplasm types that can be coded under this category
  • Need for precise documentation of the tumor's location and characteristics
  • Differentiation from malignant neoplasms in clinical documentation
  • Potential for overlapping symptoms with other conditions

Audit Risk Factors

  • Inadequate documentation of tumor characteristics
  • Failure to specify the exact location of the neoplasm
  • Misclassification of benign neoplasms as malignant
  • Lack of follow-up documentation post-surgery

Specialty Focus

Medical Specialties

Oncology

Documentation Requirements

Detailed pathology reports and imaging studies must be included to support diagnosis.

Common Clinical Scenarios

Patients presenting with a mass in the left upper limb requiring evaluation and potential excision.

Billing Considerations

Ensure clear differentiation between benign and malignant neoplasms in documentation.

Orthopedics

Documentation Requirements

Surgical notes and post-operative follow-up documentation are critical.

Common Clinical Scenarios

Management of soft tissue tumors affecting mobility or causing pain in the shoulder region.

Billing Considerations

Document functional impact and any associated musculoskeletal symptoms.

Coding Guidelines

Inclusion Criteria

Use D21.12 When
  • According to ICD
  • 10 coding guidelines, D21
  • 12 should be used when the neoplasm is confirmed as benign and located specifically in the left upper limb
  • Coders must ensure that the diagnosis is supported by appropriate clinical documentation, including imaging and pathology reports

Exclusion Criteria

Do NOT use D21.12 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

11400CPT Code

Excision, benign lesion, face, ears, eyelids, scalp; excised diameter less than 1.0 cm

Clinical Scenario

Used when excising a benign neoplasm from the left upper limb.

Documentation Requirements

Surgical notes detailing the procedure and pathology report.

Specialty Considerations

Orthopedic or surgical specialty notes may be required.

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. D21.12 provides specificity that was not available in ICD-9, enhancing clinical documentation and coding practices.

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. D21.12 provides specificity that was not available in ICD-9, enhancing clinical documentation and coding practices.

Reimbursement & Billing Impact

reimbursement processes. D21.12 provides specificity that was not available in ICD-9, enhancing clinical documentation and coding practices.

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 difference between benign and malignant neoplasms?

Benign neoplasms are non-cancerous growths that do not invade surrounding tissues or metastasize, while malignant neoplasms are cancerous and can spread to other parts of the body.