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ICD-10 Guide
ICD-10 CodesD21.5

D21.5

Billable

Benign neoplasm of connective and other soft tissue of pelvis

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

Code Description

ICD-10 D21.5 is a billable code used to indicate a diagnosis of benign neoplasm of connective and other soft tissue of pelvis.

Key Diagnostic Point:

D21.5 refers to benign neoplasms that arise from connective tissues or other soft tissues located in the pelvic region. These neoplasms can include lipomas, fibromas, and other soft tissue tumors that are non-cancerous. The pelvic area encompasses various structures, including muscles, ligaments, and connective tissues surrounding the reproductive organs, bladder, and rectum. While benign, these neoplasms can cause symptoms such as pain, discomfort, or pressure effects on adjacent organs. Diagnosis typically involves imaging studies such as ultrasound, MRI, or CT scans, and may require biopsy for definitive characterization. Management often includes monitoring for changes in size or symptoms, and surgical intervention may be necessary if the neoplasm causes significant symptoms or complications. Follow-up care is essential to ensure that the neoplasm remains benign and does not progress or recur.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of benign neoplasms that can be coded under this category
  • Need for precise documentation of the tumor type and location
  • Differentiation from malignant neoplasms in clinical documentation
  • Potential for overlapping symptoms with other pelvic conditions

Audit Risk Factors

  • Inadequate documentation of the tumor's characteristics
  • Failure to specify the exact location within the pelvis
  • Misclassification of benign neoplasms as malignant
  • Lack of follow-up documentation post-management

Specialty Focus

Medical Specialties

Oncology

Documentation Requirements

Detailed pathology reports and imaging studies must be included to confirm the benign nature of the neoplasm.

Common Clinical Scenarios

Patients presenting with pelvic pain or discomfort, requiring imaging to evaluate for soft tissue masses.

Billing Considerations

Ensure clear documentation of tumor type and any changes in size or symptoms during follow-up.

Urology

Documentation Requirements

Urological evaluations and imaging studies to assess the impact of the neoplasm on urinary function.

Common Clinical Scenarios

Patients with urinary symptoms or pelvic masses requiring surgical intervention.

Billing Considerations

Document any urinary symptoms and the relationship to the neoplasm for accurate coding.

Coding Guidelines

Inclusion Criteria

Use D21.5 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the diagnosis is supported by clinical documentation
  • Include any relevant imaging or pathology reports that confirm the benign nature of the neoplasm

Exclusion Criteria

Do NOT use D21.5 When
  • Exclude malignant neoplasms and ensure that the neoplasm is specifically located in the pelvic region

Related ICD-10 Codes

Related CPT Codes

19120CPT Code

Excision, benign lesion, face, ears, eyelids, scalp, neck

Clinical Scenario

Used when a benign neoplasm in the pelvic area is surgically excised.

Documentation Requirements

Surgical notes detailing the excision and pathology results.

Specialty Considerations

Ensure that the excision is documented as related to the benign neoplasm.

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. D21.5 provides a clear distinction from malignant neoplasms, which is crucial for treatment planning and 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. D21.5 provides a clear distinction from malignant neoplasms, which is crucial for treatment planning and patient management.

Reimbursement & Billing Impact

reimbursement processes. D21.5 provides a clear distinction from malignant neoplasms, which is crucial for treatment planning and 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 is the significance of coding D21.5 accurately?

Accurate coding of D21.5 is essential for proper reimbursement, ensuring that the benign nature of the neoplasm is recognized, and for appropriate management of the patient's condition.