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ICD-10 Guide
ICD-10 CodesD40.10

D40.10

Billable

Neoplasm of uncertain behavior of unspecified testis

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

Code Description

ICD-10 D40.10 is a billable code used to indicate a diagnosis of neoplasm of uncertain behavior of unspecified testis.

Key Diagnostic Point:

D40.10 refers to a neoplasm of uncertain behavior located in the testis, which is not classified as malignant or benign. These neoplasms may present as masses or lesions in the testicular region and can vary in their potential for progression. The term 'uncertain behavior' indicates that the neoplasm does not fit neatly into the categories of benign or malignant, making it challenging for clinicians to determine the appropriate management strategy. Surveillance is critical for these patients, as some neoplasms may exhibit malignant characteristics over time. Regular monitoring through imaging and clinical evaluations is essential to assess any changes in size or behavior. The diagnosis often requires a combination of imaging studies, histopathological examination, and clinical correlation to establish a management plan. Given the potential for progression, timely intervention may be necessary, and the decision-making process should involve a multidisciplinary team, including urologists and oncologists.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Uncertainty in behavior classification
  • Need for comprehensive documentation
  • Potential for progression requiring ongoing surveillance
  • Variability in clinical presentation

Audit Risk Factors

  • Inadequate documentation of clinical findings
  • Failure to document surveillance plans
  • Misclassification of neoplasm behavior
  • Lack of follow-up notes

Specialty Focus

Medical Specialties

Urology

Documentation Requirements

Detailed clinical notes, imaging results, and pathology reports.

Common Clinical Scenarios

Patients presenting with testicular masses, abnormal ultrasound findings, or incidental findings during imaging.

Billing Considerations

Ensure clear documentation of the neoplasm's behavior and any changes over time.

Oncology

Documentation Requirements

Comprehensive treatment plans, follow-up notes, and multidisciplinary team discussions.

Common Clinical Scenarios

Patients undergoing surveillance for testicular neoplasms with uncertain behavior.

Billing Considerations

Document any changes in the neoplasm's characteristics and the rationale for treatment decisions.

Coding Guidelines

Inclusion Criteria

Use D40.10 When
  • According to ICD
  • 10 guidelines, D40
  • 10 should be used when the neoplasm's behavior is uncertain and cannot be classified as benign or malignant
  • It is essential to document the clinical findings and any imaging or pathology results that support the diagnosis

Exclusion Criteria

Do NOT use D40.10 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

88305CPT Code

Pathology examination of tissue

Clinical Scenario

Used when a biopsy is performed to determine the nature of the neoplasm.

Documentation Requirements

Pathology report detailing the findings and diagnosis.

Specialty Considerations

Urologists and oncologists should ensure that the pathology report is comprehensive and correlates with clinical findings.

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 of patient outcomes and treatment effectiveness.

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 of patient outcomes and treatment effectiveness.

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 of patient outcomes and treatment effectiveness.

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 'uncertain behavior' mean in the context of D40.10?

Uncertain behavior indicates that the neoplasm cannot be definitively classified as benign or malignant, necessitating careful monitoring and evaluation.

How often should patients with D40.10 be monitored?

Patients should be monitored regularly, with follow-up imaging and clinical evaluations typically performed every 3 to 6 months, depending on the neoplasm's characteristics.