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v1.0.0
ICD-10 Guide
ICD-10 CodesD13.9

D13.9

Billable

Benign neoplasm of ill-defined sites within the digestive system

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

Code Description

ICD-10 D13.9 is a billable code used to indicate a diagnosis of benign neoplasm of ill-defined sites within the digestive system.

Key Diagnostic Point:

D13.9 refers to benign neoplasms located in unspecified or ill-defined sites within the digestive system. These neoplasms are non-cancerous growths that can occur in various parts of the digestive tract, including the esophagus, stomach, intestines, and other associated organs. While benign, these neoplasms can still lead to complications such as obstruction, bleeding, or discomfort, necessitating careful monitoring and management. Surveillance is crucial, as some benign neoplasms may have the potential to undergo malignant transformation, particularly if they exhibit atypical features or if there is a family history of gastrointestinal cancers. Regular follow-up with imaging studies or endoscopic evaluations may be warranted to assess any changes in size or characteristics of the neoplasm. Accurate coding of D13.9 is essential for proper treatment planning and resource allocation in healthcare settings.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in documentation of neoplasm location
  • Need for differentiation from malignant neoplasms
  • Potential for misclassification with other digestive disorders
  • Variability in clinical presentation and symptoms

Audit Risk Factors

  • Inadequate documentation of the neoplasm's characteristics
  • Failure to document follow-up or surveillance plans
  • Misclassification with malignant neoplasms
  • Inconsistent terminology used in clinical notes

Specialty Focus

Medical Specialties

Gastroenterology

Documentation Requirements

Detailed descriptions of the neoplasm's location, size, and characteristics, as well as any imaging or biopsy results.

Common Clinical Scenarios

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

Billing Considerations

Ensure that the documentation clearly differentiates between benign and malignant neoplasms to avoid coding errors.

Oncology

Documentation Requirements

Comprehensive reports on the nature of the neoplasm, including histopathological findings and treatment plans.

Common Clinical Scenarios

Patients with a history of benign neoplasms undergoing surveillance for potential malignant transformation.

Billing Considerations

Documentation should include any family history of cancer and previous biopsies to assess risk.

Coding Guidelines

Inclusion Criteria

Use D13.9 When
  • According to the official ICD
  • CM coding guidelines, D13
  • 9 should be used when the specific site of the benign neoplasm is not documented
  • Coders should ensure that the diagnosis is confirmed by clinical documentation and that the neoplasm is indeed benign

Exclusion Criteria

Do NOT use D13.9 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

45380CPT Code

Colonoscopy, flexible, diagnostic

Clinical Scenario

Used for surveillance of benign neoplasms in the colon.

Documentation Requirements

Document findings, including size and characteristics of the neoplasm.

Specialty Considerations

Gastroenterologists should ensure clear documentation of the neoplasm's nature.

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. D13.9 provides a clear designation for ill-defined sites, which was less specific in ICD-9.

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. D13.9 provides a clear designation for ill-defined sites, which was less specific in ICD-9.

Reimbursement & Billing Impact

reimbursement processes. D13.9 provides a clear designation for ill-defined sites, which was less specific in ICD-9.

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 D13.9?

Coding D13.9 accurately reflects the presence of a benign neoplasm in the digestive system, which is crucial for treatment planning and monitoring for potential complications or malignant transformation.