ICD-10 Coding for Benign Brain Tumor(D33.0, D33.1, Z86.011)
Complete ICD-10-CM coding and documentation guide for Benign Brain Tumor. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Benign Brain Tumor
D33.0-D33.9Primary Range
Benign neoplasms of brain and other parts of central nervous system
This range includes codes for benign brain tumors, differentiating by location and behavior.
Personal history of benign neoplasm of brain
Used for patients with a history of benign brain tumors that are no longer active.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| D33.0 | Benign neoplasm of brain, supratentorial | Use when imaging confirms a benign tumor in the supratentorial region. |
|
| D33.1 | Benign neoplasm of brain, infratentorial | Use when imaging confirms a benign tumor in the infratentorial region. |
|
| Z86.011 | Personal history of benign neoplasm of brain | Use for patients with a history of benign brain tumors that are no longer active. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for benign brain tumor
Essential facts and insights about Benign Brain Tumor
Primary ICD-10-CM Codes for benign brain tumor
Decision Criteria
clinical Criteria
- Confirmed benign tumor in supratentorial region
Applicable To
- Benign tumor in the supratentorial region
Excludes
- Malignant neoplasm of brain (C71.-)
Clinical Validation Requirements
- MRI showing supratentorial mass
- Histopathology report confirming benign nature
Code-Specific Risks
- Misclassification if site is not specified
Coding Notes
- Ensure the site is specified as supratentorial to avoid unspecified coding.
D33.1 - Benign neoplasm of brain, infratentorial
Use when imaging confirms a benign tumor in the infratentorial region.
Applicable To
- Benign tumor in the infratentorial region
Excludes
- Malignant neoplasm of brain (C71.-)
Clinical Validation Requirements
- MRI showing infratentorial mass
- Histopathology report confirming benign nature
Coding Notes
Ensure the site is specified as infratentorial to avoid unspecified coding.
Z86.011 - Personal history of benign neoplasm of brain
Use for patients with a history of benign brain tumors that are no longer active.
Applicable To
- History of benign brain tumor
Excludes
- Current benign brain tumor (D33.-)
Clinical Validation Requirements
- Documentation of prior resection
- Current imaging showing no active tumor
Coding Notes
Ensure documentation supports history status and no active disease.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Benign Brain Tumor to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code D33.0.
Impact
Clinical: Leads to unspecified coding, affecting treatment decisions., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials due to lack of specificity.
Mitigation Strategy
Train staff on importance of site-specific documentation., Implement checklist for documentation completeness.
Impact
Reimbursement: Incorrect use may lead to claim denials., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate patient records.
Mitigation Strategy
Reserve Z86.011 for history only after treatment completion.
Impact
Failure to document specific tumor site can lead to audit findings.
Mitigation Strategy
Implement regular documentation audits and training.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Benign Brain Tumor, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Benign Brain Tumor
Use these documentation templates to ensure complete and accurate documentation for Benign Brain Tumor. These templates include all required elements for proper coding and billing.
Neurosurgery Progress Note
Specialty: NeurosurgeryRequired Elements
- Patient symptoms
- MRI findings
- Histopathology results
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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