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ICD-10 Guide
ICD-10 CodesD24.1

D24.1

Billable

Benign neoplasm of right breast

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

Code Description

ICD-10 D24.1 is a billable code used to indicate a diagnosis of benign neoplasm of right breast.

Key Diagnostic Point:

A benign neoplasm of the right breast refers to a non-cancerous tumor that arises from the breast tissue. These neoplasms can include various types of growths such as fibroadenomas, lipomas, and cysts. They are typically characterized by well-defined borders and do not invade surrounding tissues or metastasize. Patients may present with a palpable mass, which can be discovered during a routine examination or imaging study. Diagnosis is often confirmed through imaging techniques such as mammography or ultrasound, followed by a biopsy if necessary. Management usually involves monitoring the neoplasm unless it causes discomfort or other complications, in which case surgical excision may be considered. Follow-up care is essential to ensure that the neoplasm does not change in character or size, and to monitor for any potential development of malignant changes. Regular clinical evaluations and imaging may be recommended based on the individual patient's risk factors and the characteristics of the neoplasm.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between benign and malignant neoplasms
  • Variability in clinical presentation and imaging findings
  • Need for precise documentation of tumor characteristics
  • Potential for co-existing conditions affecting coding

Audit Risk Factors

  • Inadequate documentation of tumor characteristics
  • Failure to specify laterality (right vs. left)
  • Misclassification of benign neoplasms as malignant
  • Lack of follow-up documentation

Specialty Focus

Medical Specialties

Oncology

Documentation Requirements

Detailed pathology reports and imaging studies must be included.

Common Clinical Scenarios

Patients presenting with breast lumps requiring biopsy or surgical intervention.

Billing Considerations

Ensure clear differentiation between benign and malignant findings in documentation.

Radiology

Documentation Requirements

Imaging reports must clearly describe the characteristics of the neoplasm.

Common Clinical Scenarios

Imaging studies performed for breast masses detected during physical exams.

Billing Considerations

Accurate coding based on imaging findings is crucial for proper diagnosis.

Coding Guidelines

Inclusion Criteria

Use D24.1 When
  • According to ICD
  • 10 coding guidelines, D24
  • 1 should be used when the neoplasm is confirmed as benign and located in the right breast

Exclusion Criteria

Do NOT use D24.1 When
  • Exclusion criteria include any malignant findings or unspecified neoplasms

Related ICD-10 Codes

Related CPT Codes

19120CPT Code

Excision, breast tumor

Clinical Scenario

Used when a benign neoplasm is surgically removed.

Documentation Requirements

Operative report detailing the procedure and findings.

Specialty Considerations

Oncology specialists must ensure accurate coding based on pathology results.

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. D24.1 provides clarity in coding for benign conditions, which can help in tracking treatment outcomes and resource allocation.

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. D24.1 provides clarity in coding for benign conditions, which can help in tracking treatment outcomes and resource allocation.

Reimbursement & Billing Impact

reimbursement processes. D24.1 provides clarity in coding for benign conditions, which can help in tracking treatment outcomes and resource allocation.

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.