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ICD-10 Guide
ICD-10 CodesD40.12

D40.12

Billable

Neoplasm of uncertain behavior of left testis

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

Code Description

ICD-10 D40.12 is a billable code used to indicate a diagnosis of neoplasm of uncertain behavior of left testis.

Key Diagnostic Point:

D40.12 refers to a neoplasm of uncertain behavior located in the left testis. Neoplasms of uncertain behavior are tumors that do not clearly fall into benign or malignant categories, making their management and prognosis challenging. These tumors may exhibit atypical cellular features, and while they are not classified as malignant, they have the potential for aggressive behavior or progression to malignancy. Surveillance is critical for these patients, as regular monitoring through imaging and clinical evaluations can help detect any changes in tumor behavior. The left testis is specifically referenced in this code, indicating the need for precise localization in documentation. Clinicians must consider factors such as tumor size, growth rate, and patient symptoms when determining the appropriate management strategy. Treatment options may vary from active surveillance to surgical intervention, depending on the tumor's characteristics and the patient's overall health. Accurate coding is essential for ensuring appropriate reimbursement and facilitating effective patient care.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Uncertainty in behavior classification
  • Need for precise localization (left testis)
  • Potential for progression to malignancy
  • Variability in treatment approaches

Audit Risk Factors

  • Inadequate documentation of tumor characteristics
  • Failure to document surveillance plans
  • Misclassification of tumor behavior
  • Lack of follow-up notes on tumor progression

Specialty Focus

Medical Specialties

Urology

Documentation Requirements

Detailed pathology reports, imaging results, and treatment plans must be documented.

Common Clinical Scenarios

Patients presenting with testicular masses, abnormal ultrasound findings, or follow-up after initial diagnosis.

Billing Considerations

Urologists should ensure clear communication of tumor behavior and management plans to facilitate accurate coding.

Oncology

Documentation Requirements

Comprehensive treatment history, including chemotherapy or radiation therapy details, if applicable.

Common Clinical Scenarios

Patients undergoing surveillance for testicular neoplasms or those with a history of testicular cancer.

Billing Considerations

Oncologists must document any changes in tumor behavior and treatment response to support coding.

Coding Guidelines

Inclusion Criteria

Use D40.12 When
  • According to ICD
  • 10 coding guidelines, neoplasms of uncertain behavior should be coded based on the site and behavior
  • Documentation must clearly indicate the tumor's characteristics and any treatment or surveillance plans

Exclusion Criteria

Do NOT use D40.12 When
  • Exclusion criteria include tumors that are definitively benign or malignant

Related ICD-10 Codes

Related CPT Codes

88305CPT Code

Pathology examination of tissue

Clinical Scenario

Used when a biopsy is performed to assess the neoplasm.

Documentation Requirements

Pathology report must clearly indicate the behavior of the neoplasm.

Specialty Considerations

Urologists and oncologists should ensure accurate coding based on pathology 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, 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, requiring careful monitoring and management.