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ICD-10 Guide
ICD-10 CodesD38.0

D38.0

Billable

Neoplasm of uncertain behavior of larynx

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

Code Description

ICD-10 D38.0 is a billable code used to indicate a diagnosis of neoplasm of uncertain behavior of larynx.

Key Diagnostic Point:

D38.0 refers to neoplasms of uncertain behavior specifically located in the larynx. These neoplasms are characterized by their ambiguous biological behavior, meaning they cannot be definitively classified as benign or malignant based on histological examination. This uncertainty necessitates careful monitoring and follow-up, as some neoplasms may exhibit malignant potential over time. Clinically, patients may present with symptoms such as hoarseness, difficulty breathing, or throat discomfort, prompting further investigation through imaging studies or biopsy. The management of these neoplasms often involves a multidisciplinary approach, including otolaryngologists, oncologists, and pathologists, to determine the best course of action, which may range from surveillance to surgical intervention. Regular surveillance is crucial due to the potential for progression to malignancy, and the decision-making process must consider patient-specific factors, including age, overall health, and the characteristics of the neoplasm itself.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Ambiguity in behavior classification
  • Need for ongoing surveillance and follow-up
  • Potential for progression to malignancy
  • Variability in clinical presentation

Audit Risk Factors

  • Inadequate documentation of clinical findings
  • Failure to document follow-up plans
  • Misclassification of neoplasm behavior
  • Lack of multidisciplinary notes

Specialty Focus

Medical Specialties

Otolaryngology

Documentation Requirements

Detailed clinical notes on symptoms, diagnostic imaging, and biopsy results.

Common Clinical Scenarios

Patients presenting with hoarseness, throat pain, or abnormal findings on laryngoscopy.

Billing Considerations

Ensure clear documentation of the neoplasm's characteristics and any changes over time.

Oncology

Documentation Requirements

Comprehensive treatment plans, including surveillance protocols and any interventions performed.

Common Clinical Scenarios

Management of patients with laryngeal neoplasms requiring chemotherapy or radiation therapy.

Billing Considerations

Document the rationale for treatment decisions based on the neoplasm's behavior.

Coding Guidelines

Inclusion Criteria

Use D38.0 When
  • According to ICD
  • 10 guidelines, D38
  • 0 should be used when the neoplasm's behavior is uncertain and specifically located in the larynx
  • Coders must ensure that the diagnosis is supported by appropriate documentation and that any related procedures are accurately linked

Exclusion Criteria

Do NOT use D38.0 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

31575CPT Code

Laryngoscopy, flexible, diagnostic

Clinical Scenario

Used to evaluate laryngeal neoplasms during initial assessment.

Documentation Requirements

Document findings from the laryngoscopy and any biopsies taken.

Specialty Considerations

Otolaryngologists should ensure thorough documentation of the procedure and findings.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of neoplasms, including those of uncertain behavior. This specificity aids in better tracking and management of these conditions, improving patient care and outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of neoplasms, including those of uncertain behavior. This specificity aids in better tracking and management of these conditions, improving patient care and outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of neoplasms, including those of uncertain behavior. This specificity aids in better tracking and management of these conditions, improving patient care and outcomes.

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 D38.0?

Coding D38.0 is crucial for identifying patients with laryngeal neoplasms that require careful monitoring due to their uncertain behavior. Accurate coding ensures appropriate management and follow-up.