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ICD-10 Guide
ICD-10 CodesD23.111

D23.111

Billable

Other benign neoplasm of skin of right upper eyelid, including canthus

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

Code Description

ICD-10 D23.111 is a billable code used to indicate a diagnosis of other benign neoplasm of skin of right upper eyelid, including canthus.

Key Diagnostic Point:

D23.111 refers to a benign neoplasm located on the skin of the right upper eyelid, including the canthus area. Benign neoplasms of the skin are non-cancerous growths that can arise from various skin cells, including keratinocytes, melanocytes, and fibroblasts. These neoplasms can present as nodules, plaques, or other forms and may vary in color, texture, and size. Common types include seborrheic keratosis, dermatofibromas, and lipomas. While these lesions are not malignant, they can cause cosmetic concerns or discomfort, particularly when located on the eyelid, which is a sensitive area. Management typically involves monitoring for changes, surgical excision, or other dermatological interventions if the neoplasm causes symptoms or aesthetic issues. Follow-up care is essential to ensure that the lesion does not recur or change in nature, which could necessitate further evaluation.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Specificity of location (right upper eyelid)
  • Differentiation from malignant neoplasms
  • Potential for cosmetic and functional implications
  • Need for precise documentation of lesion characteristics

Audit Risk Factors

  • Inadequate documentation of lesion characteristics
  • Failure to specify the exact location
  • Misclassification as malignant
  • Lack of follow-up documentation

Specialty Focus

Medical Specialties

Dermatology

Documentation Requirements

Detailed descriptions of the lesion, including size, color, and texture, as well as any symptoms.

Common Clinical Scenarios

Evaluation of a patient presenting with a new skin lesion on the eyelid, follow-up after excision.

Billing Considerations

Ensure that the documentation clearly states the benign nature of the neoplasm and any treatment provided.

Ophthalmology

Documentation Requirements

Visual acuity tests, assessment of eyelid function, and detailed descriptions of the lesion.

Common Clinical Scenarios

Management of eyelid lesions affecting vision or causing discomfort.

Billing Considerations

Document any impact on ocular health and the need for surgical intervention.

Coding Guidelines

Inclusion Criteria

Use D23.111 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the code is used only for benign neoplasms of the specified location

Exclusion Criteria

Do NOT use D23.111 When
  • Exclude malignant neoplasms and ensure accurate documentation of the lesion's characteristics

Related ICD-10 Codes

Related CPT Codes

11420CPT Code

Excision, benign lesion, face, ears, eyelids

Clinical Scenario

Used when excising a benign neoplasm from the right upper eyelid.

Documentation Requirements

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

Specialty Considerations

Ensure that the excision is justified based on the lesion's characteristics.

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. D23.111 provides specificity that was not available 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. D23.111 provides specificity that was not available in ICD-9.

Reimbursement & Billing Impact

reimbursement processes. D23.111 provides specificity that was not available 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 D23.111 accurately?

Accurate coding of D23.111 is crucial for proper reimbursement, tracking of benign skin lesions, and ensuring appropriate patient management. It helps differentiate benign conditions from malignant ones, guiding treatment decisions.