D13.5 — Benign neoplasm of extrahepatic bile ducts
D13.5 is a billable, specific ICD-10-CM code for benign neoplasm of extrahepatic bile ducts. It is valid for submission on a claim.
Risk adjustment
D13.5 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
D13.5 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.
- A56389Billing and Coding: Upper Gastrointestinal Endoscopy and Visualization
- A56421Billing and Coding: CT of the Abdomen and Pelvis
- A56580Billing and Coding: Computerized Axial Tomography (CT), Thorax
- A56695Billing and Coding: Implantable Infusion Pump
How D13.5 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to D13.5.
- Adenoma›bile duct›common
- Adenoma›bile duct›extrahepatic
Related codes at this level
Codes that share D13. If D13.5 is not quite right, the correct code is usually one of these.
- D13.0Benign neoplasm of esophagus
- D13.1Benign neoplasm of stomach
- D13.2Benign neoplasm of duodenum
- D13.3Benign neoplasm of other and unspecified parts of small intestine
- D13.4Benign neoplasm of liver
- D13.6Benign neoplasm of pancreas
- D13.7Benign neoplasm of endocrine pancreas
- D13.9Benign neoplasm of ill-defined sites within the digestive system
Questions about D13.5
- Is D13.5 a billable ICD-10-CM code?
- Yes. D13.5 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does D13.5 sit in the tabular list?
- Neoplasms (C00-D49), in the block Benign neoplasms, except benign neuroendocrine tumors (D10-D36).