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ICD-10 Guide
ICD-10 CodesD48.117

D48.117

Billable

Desmoid tumor of back

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

Code Description

ICD-10 D48.117 is a billable code used to indicate a diagnosis of desmoid tumor of back.

Key Diagnostic Point:

A desmoid tumor, also known as aggressive fibromatosis, is a benign but locally aggressive neoplasm that arises from the connective tissue, particularly the fascia and muscle. Desmoid tumors can occur in various anatomical locations, with the back being one of the less common sites. These tumors are characterized by their infiltrative growth pattern and potential for local recurrence, although they do not metastasize to distant sites. Clinically, patients may present with a palpable mass, pain, or discomfort in the affected area. Imaging studies, such as MRI, are often utilized to assess the extent of the tumor and its relationship to surrounding structures. The management of desmoid tumors can be challenging due to their unpredictable behavior; some may remain stable, while others can grow aggressively. Treatment options vary and may include surgical excision, observation, or pharmacological interventions such as nonsteroidal anti-inflammatory drugs (NSAIDs) or hormonal therapies. Surveillance is crucial, as these tumors can recur locally after treatment. The coding for desmoid tumors requires careful consideration of the tumor's behavior and location, making accurate documentation essential for appropriate coding and billing.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in tumor behavior and growth patterns
  • Need for precise anatomical localization
  • Differentiation from other neoplasms
  • Potential for recurrence requiring ongoing surveillance

Audit Risk Factors

  • Inadequate documentation of tumor characteristics
  • Failure to document treatment plans and outcomes
  • Misclassification of tumor behavior
  • Lack of follow-up notes indicating surveillance

Specialty Focus

Medical Specialties

Oncology

Documentation Requirements

Detailed pathology reports, imaging studies, and treatment plans.

Common Clinical Scenarios

Patients presenting with a palpable mass in the back, requiring imaging and potential surgical intervention.

Billing Considerations

Ensure accurate documentation of tumor behavior and treatment response.

Orthopedic Surgery

Documentation Requirements

Surgical notes, pre-operative assessments, and post-operative follow-up.

Common Clinical Scenarios

Surgical excision of desmoid tumors in the back, with consideration of surrounding structures.

Billing Considerations

Document the extent of resection and any complications.

Coding Guidelines

Inclusion Criteria

Use D48.117 When
  • According to ICD
  • 10 coding guidelines, D48
  • 117 should be used for desmoid tumors of the back, ensuring that the documentation supports the diagnosis and reflects the tumor's behavior

Exclusion Criteria

Do NOT use D48.117 When
  • Exclusion criteria include tumors that are definitively malignant or benign without uncertain behavior

Related ICD-10 Codes

Related CPT Codes

19301CPT Code

Excision, tumor, soft tissue of back

Clinical Scenario

Used when a desmoid tumor is surgically excised from the back.

Documentation Requirements

Operative report detailing the procedure and findings.

Specialty Considerations

Orthopedic surgeons should document the extent of resection and any complications.

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 desmoid tumors, which aids in better tracking and management of these conditions. The specificity helps in understanding the epidemiology and treatment outcomes associated with desmoid tumors.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of neoplasms, including desmoid tumors, which aids in better tracking and management of these conditions. The specificity helps in understanding the epidemiology and treatment outcomes associated with desmoid tumors.

Reimbursement & Billing Impact

reimbursement and to avoid denials.

Resources

Clinical References

  • •
    American Cancer Society - Desmoid Tumors

Coding & Billing References

  • •
    American Cancer Society - Desmoid Tumors

Frequently Asked Questions

What is a desmoid tumor?

A desmoid tumor is a benign but locally aggressive neoplasm that arises from connective tissue, characterized by infiltrative growth and potential for local recurrence.

How are desmoid tumors treated?

Treatment options for desmoid tumors may include surgical excision, observation, and pharmacological therapies such as NSAIDs or hormonal treatments.

What are the risks associated with desmoid tumors?

While desmoid tumors do not metastasize, they can cause significant local morbidity due to their aggressive growth and potential for recurrence.