Is D16.00 a billable ICD-10-CM code?

Yes. D16.00 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does D16.00 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 D16.00?

D16.00 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above D16.00 (D16) and apply to it just the same.

D16.00

D16.00 — Benign neoplasm of scapula and long bones of unspecified upper limb

Billable / specific codeICD-10-CMunspecified

D16.00 is a billable, specific ICD-10-CM code for benign neoplasm of scapula and long bones of unspecified upper limb. It is valid for submission on a claim.

Excludes1 inherited from the categories above D16.00

These are not written on D16.00, but they bind it: a note on a category applies to every code beneath it. Billing D16.00 with anything listed here is a denial.

Written on D16 — Benign neoplasm of bone and articular cartilage

benign neoplasm of connective tissue of ear (D21.0)
benign neoplasm of connective tissue of eyelid (D21.0)
benign neoplasm of connective tissue of larynx (D14.1)
benign neoplasm of connective tissue of nose (D14.0)
benign neoplasm of synovia (D21.-)

Other codes that can never be billed with D16.00

These codes carry an Excludes1 note pointing at D16.00. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading D16.00 alone.

D21Other benign neoplasms of connective and other soft tissue

Risk adjustment

D16.00 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

D16.00 is named in 2 Medicare coverage policies — 2 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A57788Billing and Coding: Peripheral Nerve Blocks
A57788Billing and Coding: Peripheral Nerve Blocks

Code history

D16.00 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share D16.0. If D16.00 is not quite right, the correct code is usually one of these.

Questions about D16.00

Is D16.00 a billable ICD-10-CM code?: Yes. D16.00 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does D16.00 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 D16.00?: D16.00 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above D16.00 (D16) and apply to it just the same.