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ICD-10 Guide
ICD-10 CodesD16.9

D16.9

Billable

Benign neoplasm of bone and articular cartilage, unspecified

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

Code Description

ICD-10 D16.9 is a billable code used to indicate a diagnosis of benign neoplasm of bone and articular cartilage, unspecified.

Key Diagnostic Point:

D16.9 refers to benign neoplasms that arise from bone and articular cartilage tissues, where the specific type of neoplasm is not specified. These tumors are generally non-cancerous and can vary in size and location. Common types of benign bone tumors include osteochondromas, enchondromas, and osteomas. While benign neoplasms typically do not metastasize, they can cause local symptoms such as pain, swelling, or functional impairment depending on their size and location. Surveillance for these tumors is essential, as some benign neoplasms may have the potential for malignant transformation, particularly if they exhibit atypical features or if there is a history of multiple lesions. Regular imaging and clinical evaluations are recommended to monitor for any changes in size or characteristics that may indicate a shift towards malignancy. Accurate coding of these conditions is crucial for appropriate management and treatment planning.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and symptoms
  • Need for precise documentation of tumor characteristics
  • Differentiation from malignant neoplasms
  • Potential for malignant transformation requiring careful monitoring

Audit Risk Factors

  • Inadequate documentation of tumor characteristics
  • Failure to specify the location of the neoplasm
  • Misclassification as malignant due to lack of clarity
  • Inconsistent follow-up documentation

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed imaging reports, surgical notes, and pathology reports.

Common Clinical Scenarios

Surgical excision of benign bone tumors, monitoring of asymptomatic lesions.

Billing Considerations

Ensure clear documentation of tumor size, location, and any symptoms to support coding.

Radiology

Documentation Requirements

Comprehensive imaging studies and interpretations.

Common Clinical Scenarios

Imaging for evaluation of suspected benign bone lesions.

Billing Considerations

Accurate reporting of imaging findings is critical for proper coding.

Coding Guidelines

Inclusion Criteria

Use D16.9 When
  • Follow official ICD
  • 10 coding guidelines, ensuring that the diagnosis is supported by clinical documentation
  • Include any relevant imaging studies and pathology reports to substantiate the diagnosis of a benign neoplasm

Exclusion Criteria

Do NOT use D16.9 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

20610CPT Code

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

Clinical Scenario

Used when a patient with a benign bone tumor presents with joint effusion.

Documentation Requirements

Document the indication for the procedure and any imaging findings.

Specialty Considerations

Orthopedic specialists should ensure clear documentation of the tumor'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. D16.9 provides a clear designation for unspecified benign neoplasms, facilitating better tracking and 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. D16.9 provides a clear designation for unspecified benign neoplasms, facilitating better tracking and management.

Reimbursement & Billing Impact

reimbursement processes. D16.9 provides a clear designation for unspecified benign neoplasms, facilitating better tracking and 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 types of benign bone neoplasms?

Common types include osteochondromas, enchondromas, and osteomas, each with distinct characteristics and management approaches.

How often should benign neoplasms be monitored?

Surveillance frequency depends on the tumor type and symptoms, but regular imaging every 6-12 months is often recommended.