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v1.0.0
ICD-10 Guide
ICD-10 CodesChapter 2: NeoplasmsD26

D26

Billable

Other benign neoplasms of uterus

Chapter 2:Neoplasms

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

Code Description

ICD-10 D26 is a billable code used to indicate a diagnosis of other benign neoplasms of uterus.

Key Diagnostic Point:

D26 refers to other benign neoplasms of the uterus, which encompasses a variety of non-cancerous growths that can occur in the uterine tissue. These neoplasms may include uterine fibroids (leiomyomas), adenomyomas, and other less common benign tumors. While many benign neoplasms are asymptomatic, they can sometimes lead to symptoms such as abnormal uterine bleeding, pelvic pain, or pressure symptoms depending on their size and location. Diagnosis typically involves imaging studies such as ultrasound or MRI, and in some cases, a biopsy may be performed to rule out malignancy. Management options vary based on the size, symptoms, and patient preferences, ranging from watchful waiting to medical management with hormonal therapies, or surgical interventions such as myomectomy or hysterectomy. Follow-up care is essential to monitor for any changes in the neoplasm or the emergence of new symptoms, ensuring that any potential complications are addressed promptly.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of benign neoplasms included under this code
  • Differentiation from malignant neoplasms
  • Need for precise documentation of symptoms and treatment
  • Variability in management approaches

Audit Risk Factors

  • Inadequate documentation of symptoms
  • Failure to specify the type of benign neoplasm
  • Misclassification of benign neoplasms as malignant
  • Lack of follow-up documentation

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed documentation of patient history, physical examination findings, imaging results, and treatment plans.

Common Clinical Scenarios

Management of symptomatic fibroids, evaluation of abnormal uterine bleeding, and pre-operative assessments.

Billing Considerations

Ensure accurate coding of the specific type of neoplasm and any associated symptoms or complications.

Radiology

Documentation Requirements

Clear imaging reports that specify the characteristics of the neoplasm and any recommendations for further management.

Common Clinical Scenarios

Ultrasound or MRI evaluations for suspected uterine neoplasms.

Billing Considerations

Radiologists should provide detailed descriptions to aid in accurate coding and management decisions.

Coding Guidelines

Inclusion Criteria

Use D26 When
  • According to ICD
  • 10 guidelines, D26 should be used when the specific type of benign neoplasm is not classified elsewhere
  • Coders should ensure that the diagnosis is supported by clinical documentation and that any related procedures are accurately linked

Exclusion Criteria

Do NOT use D26 When
No specific exclusions found.

Related CPT Codes

58150CPT Code

Total abdominal hysterectomy

Clinical Scenario

Used when a patient with benign neoplasms requires surgical intervention.

Documentation Requirements

Operative report detailing the procedure and indication for surgery.

Specialty Considerations

Obstetricians should ensure that the diagnosis supports the need for surgery.

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 diagnoses and treatment plans. D26 provides a broader category for benign neoplasms, which helps in capturing a wider range of conditions.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of benign neoplasms, improving the accuracy of diagnoses and treatment plans. D26 provides a broader category for benign neoplasms, which helps in capturing a wider range of conditions.

Reimbursement & Billing Impact

reimbursement.

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 types of neoplasms are included under D26?

D26 includes various benign neoplasms such as uterine fibroids, adenomyomas, and other non-cancerous growths of the uterus.

How do I differentiate between benign and malignant neoplasms in coding?

Documentation should clearly state the diagnosis, and any imaging or biopsy results should be included to support the benign classification.