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ICD-10 Guide
ICD-10 CodesD21.20

D21.20

Billable

Benign neoplasm of connective and other soft tissue of unspecified lower limb, including hip

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

Code Description

ICD-10 D21.20 is a billable code used to indicate a diagnosis of benign neoplasm of connective and other soft tissue of unspecified lower limb, including hip.

Key Diagnostic Point:

Benign neoplasms of connective and other soft tissues in the lower limb, including the hip, are non-cancerous growths that arise from the connective tissues such as fat, muscle, and fibrous tissues. These neoplasms can vary in size and may present as palpable masses or be asymptomatic. Common types include lipomas, fibromas, and hemangiomas. Diagnosis typically involves imaging studies such as ultrasound or MRI, and histological examination may be necessary for definitive diagnosis. Management often includes observation for asymptomatic lesions, while symptomatic or growing neoplasms may require surgical excision. Follow-up care is essential to monitor for recurrence or complications, particularly in cases where surgical intervention has occurred. The prognosis for benign neoplasms is generally favorable, with low rates of recurrence post-excision.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in presentation and symptoms of benign neoplasms
  • Need for precise documentation of location and type of neoplasm
  • Differentiation from malignant neoplasms
  • Potential for multiple neoplasms in a single patient

Audit Risk Factors

  • Inadequate documentation of the neoplasm's characteristics
  • Failure to specify the exact 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 descriptions of the neoplasm, imaging results, and treatment plans.

Common Clinical Scenarios

Surgical excision of a symptomatic lipoma in the thigh.

Billing Considerations

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

Oncology

Documentation Requirements

Histological confirmation of benign nature and follow-up care plans.

Common Clinical Scenarios

Monitoring a patient with multiple benign soft tissue tumors.

Billing Considerations

Differentiation from malignant tumors is critical; ensure pathology reports are included.

Coding Guidelines

Inclusion Criteria

Use D21.20 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the code is used only when the neoplasm is confirmed as benign and the location is accurately documented

Exclusion Criteria

Do NOT use D21.20 When
  • Exclude codes for malignant neoplasms and ensure that the neoplasm is not part of a more specific diagnosis

Related ICD-10 Codes

Related CPT Codes

11400CPT Code

Excision, benign skin lesion

Clinical Scenario

Used when excising a benign neoplasm from the lower limb.

Documentation Requirements

Document the size, location, and type of lesion excised.

Specialty Considerations

Orthopedic surgeons should ensure clear linkage between the diagnosis and the procedure performed.

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. D21.20 provides a clear classification for benign neoplasms of the lower limb, 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. D21.20 provides a clear classification for benign neoplasms of the lower limb, which aids in clinical management and research.

Reimbursement & Billing Impact

reimbursement processes. D21.20 provides a clear classification for benign neoplasms of the lower limb, 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 difference between benign and malignant neoplasms?

Benign neoplasms are non-cancerous growths that do not invade surrounding tissues or metastasize, while malignant neoplasms are cancerous and can spread to other parts of the body.