Is D10.4 a billable ICD-10-CM code?

Yes. D10.4 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does D10.4 sit in the tabular list?

Neoplasms (C00-D49), in the block Benign neoplasms, except benign neuroendocrine tumors (D10-D36).

What cannot be coded together with D10.4?

D10.4 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

D10.4

D10.4 — Benign neoplasm of tonsil

Billable / specific codeICD-10-CM

D10.4 is a billable, specific ICD-10-CM code for benign neoplasm of tonsil. It is valid for submission on a claim.

Excludes1 — never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

benign neoplasm of lingual tonsil (D10.1)
benign neoplasm of pharyngeal tonsil (D10.6)
benign neoplasm of tonsillar fossa (D10.5)
benign neoplasm of tonsillar pillars (D10.5)

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Benign neoplasm of tonsil (faucial) (palatine)

Risk adjustment

D10.4 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

Medicare coverage

D10.4 is named in 10 Medicare coverage policies — 10 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A56464Billing and Coding: Flow Cytometry
A56580Billing and Coding: Computerized Axial Tomography (CT), Thorax
A56658Billing and Coding: Cosmetic and Reconstructive Surgery
A56695Billing and Coding: Implantable Infusion Pump

Related codes at this level

Codes that share D10. If D10.4 is not quite right, the correct code is usually one of these.

Questions about D10.4

Is D10.4 a billable ICD-10-CM code?: Yes. D10.4 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does D10.4 sit in the tabular list?: Neoplasms (C00-D49), in the block Benign neoplasms, except benign neuroendocrine tumors (D10-D36).
What cannot be coded together with D10.4?: D10.4 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.