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ICD-10 Guide
ICD-10 CodesD44.1

D44.1

Billable

Neoplasm of uncertain behavior of adrenal gland

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

Code Description

ICD-10 D44.1 is a billable code used to indicate a diagnosis of neoplasm of uncertain behavior of adrenal gland.

Key Diagnostic Point:

D44.1 refers to neoplasms of uncertain behavior specifically located in the adrenal gland. These neoplasms are characterized by their ambiguous histological features, which do not clearly classify them as benign or malignant. The adrenal glands, located atop each kidney, are responsible for producing hormones that regulate metabolism, immune response, and stress reactions. Neoplasms in this area can arise from various cell types, including cortical and medullary cells, and may present with symptoms such as hormonal imbalances, abdominal pain, or incidental findings on imaging studies. Due to their uncertain behavior, these neoplasms require careful surveillance and monitoring to assess for potential progression to malignancy. Regular imaging and hormonal evaluations are essential to determine the growth rate and functional status of the neoplasm, guiding clinical management and intervention strategies. The complexity of managing these neoplasms lies in the need for multidisciplinary approaches, including endocrinology, oncology, and surgery, to ensure optimal patient outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Ambiguity in histological classification
  • Need for ongoing surveillance and monitoring
  • Potential for progression to malignancy
  • Multidisciplinary management requirements

Audit Risk Factors

  • Inadequate documentation of surveillance plans
  • Failure to specify the behavior of the neoplasm
  • Lack of follow-up notes on imaging results
  • Misclassification of benign versus uncertain behavior

Specialty Focus

Medical Specialties

Endocrinology

Documentation Requirements

Detailed hormonal assessment results and imaging studies.

Common Clinical Scenarios

Patients presenting with adrenal incidentalomas or hormonal excess syndromes.

Billing Considerations

Ensure clear documentation of hormonal levels and any changes over time.

Oncology

Documentation Requirements

Comprehensive pathology reports and treatment plans.

Common Clinical Scenarios

Management of patients with uncertain behavior neoplasms requiring potential surgical intervention.

Billing Considerations

Document the rationale for surveillance versus intervention.

Coding Guidelines

Inclusion Criteria

Use D44.1 When
  • According to ICD
  • 10 coding guidelines, D44
  • 1 should be used when the neoplasm's behavior is uncertain, and there is no definitive diagnosis of malignancy or benignity
  • It is essential to document the clinical rationale for using this code, including any imaging or laboratory findings that support the diagnosis

Exclusion Criteria

Do NOT use D44.1 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

74177CPT Code

CT scan of abdomen and pelvis

Clinical Scenario

Used for initial evaluation and follow-up of adrenal neoplasms.

Documentation Requirements

Document the indication for the scan and any findings related to the neoplasm.

Specialty Considerations

Endocrinologists should ensure that imaging correlates with hormonal evaluations.

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

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 does 'neoplasm of uncertain behavior' mean?

It refers to a tumor that cannot be definitively classified as benign or malignant based on histological examination. These tumors require careful monitoring to assess for potential changes in behavior.