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ICD-10 Guide
ICD-10 CodesD11.7

D11.7

Billable

Benign neoplasm of other major salivary glands

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

Code Description

ICD-10 D11.7 is a billable code used to indicate a diagnosis of benign neoplasm of other major salivary glands.

Key Diagnostic Point:

Benign neoplasms of the salivary glands are non-cancerous tumors that can arise in the major salivary glands, which include the parotid, submandibular, and sublingual glands, as well as other minor salivary glands. These neoplasms can present as painless swellings and may be discovered incidentally during imaging studies or physical examinations. Common types of benign salivary gland tumors include pleomorphic adenomas, Warthin's tumors, and oncocytomas. Although these tumors are generally not life-threatening, they can cause discomfort, functional impairment, or cosmetic concerns depending on their size and location. Surveillance for benign neoplasms is essential, as there is a small risk of malignant transformation, particularly in long-standing cases. Regular follow-up with imaging and clinical evaluation is recommended to monitor for any changes in size or characteristics that may suggest malignancy. Surgical excision is often the treatment of choice, especially if the tumor is symptomatic or shows signs of growth. Accurate coding for benign neoplasms is crucial for appropriate management and reimbursement.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiation between benign and malignant neoplasms
  • Variety of benign neoplasm types and their specific characteristics
  • Need for precise documentation of tumor location and type
  • Potential for malignant transformation requiring careful monitoring

Audit Risk Factors

  • Inadequate documentation of tumor characteristics
  • Failure to note the location of the neoplasm
  • Misclassification of benign neoplasms as malignant
  • Lack of follow-up documentation for surveillance

Specialty Focus

Medical Specialties

Otolaryngology

Documentation Requirements

Detailed descriptions of the tumor's size, location, and histological type are essential.

Common Clinical Scenarios

Evaluation of a patient with a palpable mass in the salivary gland region.

Billing Considerations

Ensure that imaging studies and biopsy results are included in the documentation.

Pathology

Documentation Requirements

Histopathological reports must clearly indicate the benign nature of the neoplasm.

Common Clinical Scenarios

Review of biopsy specimens from salivary gland masses.

Billing Considerations

Accurate reporting of tumor type and differentiation is critical for coding.

Coding Guidelines

Inclusion Criteria

Use D11.7 When
  • According to the official ICD
  • CM coding guidelines, D11
  • 7 should be used when a benign neoplasm of the major salivary glands is diagnosed
  • Coders must ensure that the documentation supports the diagnosis and that the neoplasm is confirmed as benign through appropriate clinical and pathological evaluations

Exclusion Criteria

Do NOT use D11.7 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

42500CPT Code

Excision of benign tumor of salivary gland

Clinical Scenario

Used when a patient undergoes surgical removal of a benign salivary gland tumor.

Documentation Requirements

Operative reports must detail the procedure and confirm the benign nature of the tumor.

Specialty Considerations

Otolaryngologists should ensure that pre-operative imaging and pathology reports are included.

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. D11.7 provides a distinct code for benign neoplasms of other major salivary glands, enhancing the granularity of clinical data.

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. D11.7 provides a distinct code for benign neoplasms of other major salivary glands, enhancing the granularity of clinical data.

Reimbursement & Billing Impact

reimbursement processes. D11.7 provides a distinct code for benign neoplasms of other major salivary glands, enhancing the granularity of clinical data.

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 type has distinct histological features and clinical implications.

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

Patients should undergo regular follow-up evaluations, typically every 6 to 12 months, to monitor for any changes in the size or characteristics of the neoplasm.