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v1.0.0
ICD-10 Guide
ICD-10 CodesD40.1

D40.1

Billable

Neoplasm of uncertain behavior of testis

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

Code Description

ICD-10 D40.1 is a billable code used to indicate a diagnosis of neoplasm of uncertain behavior of testis.

Key Diagnostic Point:

D40.1 refers to a neoplasm of uncertain behavior of the testis, which encompasses tumors that do not fit neatly into benign or malignant categories. These neoplasms may exhibit atypical cellular characteristics, making it challenging to predict their clinical behavior. The term 'uncertain behavior' indicates that while the tumor may not currently show aggressive features, there is a potential for progression to malignancy. Surveillance is critical for these patients, as regular monitoring can help detect any changes in tumor behavior. The management of such neoplasms often involves a multidisciplinary approach, including urologists, oncologists, and pathologists, to ensure appropriate follow-up and intervention if necessary. The diagnosis typically arises from imaging studies and histopathological examination, where the tumor's characteristics are assessed. Given the uncertainty surrounding these neoplasms, patient education regarding symptoms and the importance of follow-up is essential.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in histological classification
  • Need for regular surveillance and follow-up
  • Potential for progression to malignancy
  • Multidisciplinary management approach

Audit Risk Factors

  • Inadequate documentation of tumor characteristics
  • Failure to document follow-up plans
  • Misclassification of tumor behavior
  • Lack of multidisciplinary notes in the medical record

Specialty Focus

Medical Specialties

Urology

Documentation Requirements

Detailed pathology reports, imaging studies, and follow-up plans.

Common Clinical Scenarios

Initial diagnosis of testicular mass, follow-up of previously diagnosed neoplasm.

Billing Considerations

Ensure clear documentation of tumor behavior and any changes noted during follow-up visits.

Oncology

Documentation Requirements

Comprehensive treatment plans, response to therapy, and ongoing surveillance results.

Common Clinical Scenarios

Management of testicular neoplasms with uncertain behavior, coordination of care with urology.

Billing Considerations

Document any multidisciplinary discussions and treatment decisions made.

Coding Guidelines

Inclusion Criteria

Use D40.1 When
  • According to ICD
  • 10 guidelines, D40
  • 1 should be used when the neoplasm is confirmed as of uncertain behavior through histological examination
  • It is essential to document the clinical findings and any imaging studies that support the diagnosis

Exclusion Criteria

Do NOT use D40.1 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

54500CPT Code

Orchiectomy, radical, for testicular cancer

Clinical Scenario

Used when surgical intervention is required for neoplasms of uncertain behavior.

Documentation Requirements

Pathology report confirming uncertain behavior and surgical notes.

Specialty Considerations

Urology must document the rationale for surgery and follow-up plans.

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, which aids in better tracking and management of these conditions.

ICD-9 vs ICD-10

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

Reimbursement & Billing Impact

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

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 does 'neoplasm of uncertain behavior' mean?

It refers to tumors that do not clearly classify as benign or malignant, indicating a need for careful monitoring due to potential for progression.