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v1.0.0
ICD-10 Guide
ICD-10 CodesD16.7

D16.7

Billable

Benign neoplasm of ribs, sternum and clavicle

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

Code Description

ICD-10 D16.7 is a billable code used to indicate a diagnosis of benign neoplasm of ribs, sternum and clavicle.

Key Diagnostic Point:

Benign neoplasms of the ribs, sternum, and clavicle are non-cancerous growths that can arise from various tissues in these areas, including bone, cartilage, and soft tissue. These neoplasms may present as asymptomatic masses or may cause localized pain or discomfort depending on their size and location. Common types of benign neoplasms in this region include osteochondromas, fibromas, and chondromas. Diagnosis typically involves imaging studies such as X-rays, CT scans, or MRIs to assess the characteristics of the neoplasm. While benign, these neoplasms require monitoring due to the potential for growth or, in rare cases, transformation into malignant forms. Regular follow-up with imaging may be necessary to ensure stability. The management of benign neoplasms may involve surgical excision if symptomatic or if there is concern for malignancy. Understanding the nature of these neoplasms is crucial for appropriate coding and treatment planning.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiation from malignant neoplasms
  • Need for precise documentation of tumor characteristics
  • Variability in clinical presentation
  • Potential for growth and transformation

Audit Risk Factors

  • Inadequate documentation of tumor characteristics
  • Failure to document follow-up imaging
  • Misclassification as malignant neoplasm
  • Lack of clinical rationale for surgical intervention

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed imaging reports, surgical notes, and pathology reports.

Common Clinical Scenarios

Surgical excision of a benign rib tumor, evaluation of a clavicular mass.

Billing Considerations

Ensure clear documentation of the tumor's size, location, and any symptoms.

Radiology

Documentation Requirements

Comprehensive imaging studies with clear descriptions of findings.

Common Clinical Scenarios

Imaging for follow-up of known benign neoplasms.

Billing Considerations

Accurate reporting of imaging findings is crucial for coding.

Coding Guidelines

Inclusion Criteria

Use D16.7 When
  • Follow ICD
  • CM guidelines for coding benign neoplasms, ensuring accurate documentation of the site and type of neoplasm
  • Include any relevant imaging or pathology reports to support the diagnosis

Exclusion Criteria

Do NOT use D16.7 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

20680CPT Code

Arthrocentesis, aspiration and/or injection into a major joint or bursa

Clinical Scenario

Used when a benign neoplasm causes joint effusion.

Documentation Requirements

Document the reason for the procedure and findings.

Specialty Considerations

Orthopedic documentation should include details of the neoplasm's impact on joint function.

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. D16.7 provides a clear distinction from malignant neoplasms, which is critical for patient management.

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. D16.7 provides a clear distinction from malignant neoplasms, which is critical for patient management.

Reimbursement & Billing Impact

reimbursement processes. D16.7 provides a clear distinction from malignant neoplasms, which is critical for patient management.

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 symptoms of benign neoplasms of the ribs, sternum, and clavicle?

Common symptoms may include localized pain, swelling, or discomfort in the affected area. Many patients may be asymptomatic and discover the neoplasm incidentally during imaging for other reasons.