ICD-10 Coding for Pituitary Tumor(D35.2, C75.1, E23.6)
Complete ICD-10-CM coding and documentation guide for Pituitary Tumor. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Pituitary Tumor
Malignant neoplasms of endocrine glands
Includes malignant pituitary tumors, such as PitNETs coded as C75.1.
Disorders of other endocrine glands
Includes hormonal dysfunctions related to pituitary tumors, such as E23.6.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| D35.2 | Benign neoplasm of pituitary gland | Use for benign pituitary tumors confirmed by imaging and histology. |
|
| C75.1 | Malignant neoplasm of pituitary gland | Use for malignant pituitary tumors confirmed by histology. |
|
| E23.6 | Other disorders of pituitary gland | Use when hormonal dysfunction is present without a detectable mass. |
|
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 pituitary tumor
Essential facts and insights about Pituitary Tumor
Primary ICD-10-CM Codes for pituitary tumor
Decision Criteria
clinical Criteria
- MRI and histology confirm benign characteristics.
Applicable To
- Pituitary adenoma
- Non-functional pituitary tumor
Excludes
- Malignant neoplasm of pituitary gland (C75.1)
Clinical Validation Requirements
- MRI confirms benign characteristics
- Histology report states 'adenoma'
Code-Specific Risks
- Misclassification if histology is not reviewed.
Coding Notes
- Ensure histology confirms benign nature before coding.
C75.1 - Malignant neoplasm of pituitary gland
Use for malignant pituitary tumors confirmed by histology.
Applicable To
- Pituitary carcinoma
- Pituitary neuroendocrine tumor (PitNET)
Excludes
- Benign neoplasm of pituitary gland (D35.2)
Clinical Validation Requirements
- Histology confirms malignancy
- Ki-67 index ≥3%
Coding Notes
Ensure malignancy is confirmed by histology.
E23.6 - Other disorders of pituitary gland
Use when hormonal dysfunction is present without a detectable mass.
Applicable To
- Hormonal dysfunction without mass
Excludes
- Pituitary tumor with mass (D35.2, C75.1)
Clinical Validation Requirements
- Hormonal imbalance confirmed by lab tests
- No mass found on imaging
Coding Notes
Ensure no mass is present before using this code.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Abnormal results of endocrine function studies
R94.8Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Pituitary Tumor to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code D35.2.
Impact
Clinical: Inaccurate surgical records, Regulatory: Non-compliance with coding standards, Financial: Potential claim denials
Mitigation Strategy
Standardize surgical documentation templates, Educate surgeons on documentation requirements
Impact
Reimbursement: Incorrect DRG assignment leading to reimbursement errors., Compliance: Non-compliance with coding standards., Data Quality: Inaccurate clinical data affecting patient records.
Mitigation Strategy
Verify histology reports for malignancy indicators.
Impact
Risk of coding errors without histology confirmation
Mitigation Strategy
Require histology reports for all tumor diagnoses.
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 Pituitary Tumor, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Pituitary Tumor
Use these documentation templates to ensure complete and accurate documentation for Pituitary Tumor. These templates include all required elements for proper coding and billing.
Pituitary tumor surgical resection
Specialty: NeurosurgeryRequired Elements
- Surgical approach
- Tumor size and location
- Histology findings
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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