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.

Check D10.4 with the rest of the claim: free scrubber

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

No CMS-HCC V28 category: this code does not change a RAF score.

Medicare coverage

D10.4 is named in 8 Medicare coverage policies: 8 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

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

Code history

Unchanged in every release from FY2024 to FY2027.