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ICD-10 Guide
ICD-10 CodesD37.030

D37.030

Billable

Neoplasm of uncertain behavior of the parotid salivary glands

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

Code Description

ICD-10 D37.030 is a billable code used to indicate a diagnosis of neoplasm of uncertain behavior of the parotid salivary glands.

Key Diagnostic Point:

Neoplasms of uncertain behavior of the parotid salivary glands refer to abnormal growths that do not exhibit definitive characteristics of malignancy or benignity. These neoplasms can arise from various cell types within the parotid gland, which is the largest of the salivary glands located near the jaw. The uncertainty in behavior implies that the growth may have the potential to progress to malignancy, necessitating careful monitoring and evaluation. Clinically, these neoplasms may present as asymptomatic masses or with symptoms such as swelling, pain, or facial nerve dysfunction. Diagnosis typically involves imaging studies, such as ultrasound or MRI, and may require biopsy for histopathological examination. The management of these neoplasms often includes regular surveillance to monitor for changes in size or behavior, and surgical intervention may be considered if there is evidence of progression or if the neoplasm becomes symptomatic. The prognosis varies based on individual factors and the specific characteristics of the neoplasm.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and symptoms
  • Need for differential diagnosis with other salivary gland tumors
  • Potential for progression to malignancy requiring ongoing surveillance
  • Documentation of imaging and biopsy results

Audit Risk Factors

  • Inadequate documentation of clinical findings
  • Failure to document surveillance plans
  • Misinterpretation of biopsy results
  • Lack of follow-up notes on neoplasm behavior

Specialty Focus

Medical Specialties

Otolaryngology

Documentation Requirements

Detailed clinical notes on symptoms, imaging results, and biopsy findings.

Common Clinical Scenarios

Evaluation of a patient with a palpable parotid mass, follow-up of previously diagnosed neoplasm.

Billing Considerations

Ensure clear documentation of the decision-making process regarding surveillance or surgical intervention.

Pathology

Documentation Requirements

Comprehensive reports on histopathological examination and differential diagnoses.

Common Clinical Scenarios

Review of biopsy specimens from parotid gland neoplasms.

Billing Considerations

Accurate classification of neoplasm behavior is crucial for appropriate coding.

Coding Guidelines

Inclusion Criteria

Use D37.030 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the neoplasm's behavior and any associated symptoms
  • Include relevant imaging and biopsy results to support the diagnosis

Exclusion Criteria

Do NOT use D37.030 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

42500CPT Code

Parotid duct diversion

Clinical Scenario

Used in cases where neoplasm causes obstructive symptoms.

Documentation Requirements

Document indications for surgery and pre-operative evaluations.

Specialty Considerations

Otolaryngology specialists should ensure thorough documentation of the surgical rationale.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of neoplasms, including those of uncertain behavior. This specificity aids in better tracking and management of these conditions, enhancing patient care and outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of neoplasms, including those of uncertain behavior. This specificity aids in better tracking and management of these conditions, enhancing patient care and outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of neoplasms, including those of uncertain behavior. This specificity aids in better tracking and management of these conditions, enhancing patient care and outcomes.

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 does 'neoplasm of uncertain behavior' mean?

It refers to a growth that does not clearly indicate whether it is benign or malignant, requiring careful monitoring and evaluation.