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v1.0.0
ICD-10 Guide
ICD-10 CodesChapter 2: NeoplasmsD11

D11

Billable

Benign neoplasm of major salivary glands

Chapter 2:Neoplasms

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

Code Description

ICD-10 D11 is a billable code used to indicate a diagnosis of benign neoplasm of major salivary glands.

Key Diagnostic Point:

Benign neoplasms of the major salivary glands, including the parotid, submandibular, and sublingual glands, are non-cancerous tumors that can arise from various cell types within these glands. Common types include pleomorphic adenomas, which are the most prevalent, and other less common forms such as Warthin's tumor and oncocytoma. These neoplasms may present as painless swellings in the affected gland and can vary in size. While benign, they may cause discomfort or functional issues, such as difficulty swallowing or speaking, depending on their size and location. Surveillance is essential as some benign tumors can exhibit atypical features that may raise concerns for malignant transformation. Regular follow-up with imaging studies and clinical evaluations is recommended to monitor for any changes in size or characteristics. Surgical excision is often the treatment of choice, particularly if the neoplasm causes symptoms or if there is uncertainty regarding its nature. Accurate coding is crucial for appropriate management and reimbursement.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between benign and malignant neoplasms
  • Variability in clinical presentation and symptoms
  • Need for imaging studies to confirm diagnosis
  • Potential for atypical features that may complicate diagnosis

Audit Risk Factors

  • Inadequate documentation of tumor characteristics
  • Failure to specify the gland involved
  • Misclassification of benign tumors as malignant
  • Lack of follow-up documentation

Specialty Focus

Medical Specialties

Otolaryngology

Documentation Requirements

Detailed descriptions of the tumor's size, location, and symptoms, along with imaging results.

Common Clinical Scenarios

Patients presenting with painless swelling in the parotid gland, or recurrent infections in the submandibular gland.

Billing Considerations

Ensure that the documentation clearly indicates the benign nature of the neoplasm and any surgical interventions performed.

Pathology

Documentation Requirements

Histopathological reports confirming the benign nature of the neoplasm.

Common Clinical Scenarios

Reviewing biopsy specimens from patients with suspected salivary gland tumors.

Billing Considerations

Accurate reporting of tumor type and characteristics is essential for proper coding.

Coding Guidelines

Inclusion Criteria

Use D11 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the diagnosis is supported by clinical documentation
  • Include any relevant imaging studies and pathology reports that confirm the diagnosis of a benign neoplasm

Exclusion Criteria

Do NOT use D11 When
No specific exclusions found.

Related CPT Codes

42500CPT Code

Parotid duct diversion

Clinical Scenario

Used in cases of obstructive sialadenitis or to manage complications of benign neoplasms.

Documentation Requirements

Document the indication for the procedure and any pre-operative imaging.

Specialty Considerations

Otolaryngologists should ensure that the procedure is justified based on 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 benign neoplasms, improving the accuracy of data collection and reimbursement processes. The granularity of ICD-10 codes enables better tracking of treatment outcomes and resource utilization.

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. The granularity of ICD-10 codes enables better tracking of treatment outcomes and resource utilization.

Reimbursement & Billing Impact

reimbursement processes. The granularity of ICD-10 codes enables better tracking of treatment outcomes and resource utilization.

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 are the common types of benign neoplasms of the salivary glands?

The most common types include pleomorphic adenomas, Warthin's tumors, and oncocytomas. Each has distinct characteristics and may require different management approaches.

How often should patients with benign salivary gland neoplasms be monitored?

Patients should be monitored regularly, typically every 6 to 12 months, with imaging studies to assess for any changes in size or characteristics of the neoplasm.