D10.5 — Benign neoplasm of other parts of oropharynx
D10.5 is a billable, specific ICD-10-CM code for benign neoplasm of other parts of oropharynx. 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.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Benign neoplasm of epiglottis, anterior aspect
- Benign neoplasm of tonsillar fossa
- Benign neoplasm of tonsillar pillars
- Benign neoplasm of vallecula
Other codes that can never be billed with D10.5
These codes carry an Excludes1 note pointing at D10.5. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading D10.5 alone.
Risk adjustment
D10.5 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
D10.5 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 D10.5 is not quite right, the correct code is usually one of these.
Questions about D10.5
- Is D10.5 a billable ICD-10-CM code?
- Yes. D10.5 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does D10.5 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 D10.5?
- D10.5 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.