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v1.0.0
ICD-10 Guide
ICD-10 CodesD13.3

D13.3

Billable

Benign neoplasm of other and unspecified parts of small intestine

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

Code Description

ICD-10 D13.3 is a billable code used to indicate a diagnosis of benign neoplasm of other and unspecified parts of small intestine.

Key Diagnostic Point:

D13.3 refers to benign neoplasms located in the small intestine that are not classified elsewhere. These neoplasms can arise from various tissues within the small intestine, including epithelial, mesenchymal, and neuroendocrine tissues. Common types of benign neoplasms in this region include adenomas, lipomas, and gastrointestinal stromal tumors (GISTs). While benign, these neoplasms can lead to complications such as obstruction, bleeding, or intussusception, necessitating careful monitoring and management. Surveillance is crucial, particularly if the neoplasm is symptomatic or if there is a family history of gastrointestinal cancers. Although benign neoplasms are not cancerous, there is a potential for malignant transformation, especially in cases of adenomatous polyps. Regular follow-up with imaging studies or endoscopic evaluations may be warranted to assess for changes in size or characteristics that could indicate a risk of malignancy.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of benign neoplasm types that can be coded under this category
  • Need for precise documentation of the neoplasm's location and characteristics
  • Potential for overlap with malignant neoplasm codes
  • Variability in clinical presentation and management strategies

Audit Risk Factors

  • Inadequate documentation of the neoplasm's characteristics
  • Failure to document surveillance or follow-up plans
  • Misclassification of benign neoplasms as malignant
  • Lack of clarity regarding the neoplasm's location

Specialty Focus

Medical Specialties

Gastroenterology

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with abdominal pain, gastrointestinal bleeding, or incidental findings on imaging.

Billing Considerations

Documentation should clearly indicate the benign nature of the neoplasm and any surveillance recommendations.

Surgical Oncology

Documentation Requirements

Operative reports detailing the excision of the neoplasm, histopathology results, and follow-up care plans.

Common Clinical Scenarios

Surgical intervention for symptomatic benign neoplasms or those with potential for malignant transformation.

Billing Considerations

Ensure that the surgical indication is well-documented to support the coding of D13.3.

Coding Guidelines

Inclusion Criteria

Use D13.3 When
  • According to ICD
  • CM guidelines, D13
  • 3 should be used when a benign neoplasm is confirmed by histological examination
  • It is important to document the specific type of neoplasm and its location

Exclusion Criteria

Do NOT use D13.3 When
  • Exclusion criteria include any neoplasms that are classified as malignant or those that are not specifically located in the small intestine

Related ICD-10 Codes

Related CPT Codes

45380CPT Code

Colonoscopy, flexible, diagnostic

Clinical Scenario

Used when a patient with a known benign neoplasm undergoes surveillance colonoscopy.

Documentation Requirements

Documentation must include indications for the procedure and findings related to the neoplasm.

Specialty Considerations

Gastroenterologists should ensure that the reason for surveillance is clearly documented.

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. D13.3 provides a clear classification for benign neoplasms of the small intestine, which aids in clinical management and research.

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. D13.3 provides a clear classification for benign neoplasms of the small intestine, which aids in clinical management and research.

Reimbursement & Billing Impact

reimbursement processes. D13.3 provides a clear classification for benign neoplasms of the small intestine, which aids in clinical management and research.

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 significance of coding D13.3 accurately?

Accurate coding of D13.3 is crucial for proper reimbursement, tracking of benign neoplasms, and ensuring appropriate surveillance and management strategies are implemented for patients.