D16.4: Benign neoplasm of bones of skull and face
D16.4 is a billable, specific ICD-10-CM code for benign neoplasm of bones of skull and face. It is valid for submission on a claim.
Check D16.4 with the rest of the claim: free scrubberExcludes2: not included here, but may coexist
The excluded condition is not part of this code, but a patient can have both. You may code both.
- benign neoplasm of lower jaw bone (D16.5)
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Benign neoplasm of maxilla (superior)
- Benign neoplasm of orbital bone
- Keratocyst of maxilla
- Keratocystic odontogenic tumor of maxilla
Excludes1 inherited from the categories above D16.4
A category’s note binds every code beneath it.
Written on D16: Benign neoplasm of bone and articular cartilage
Other codes that can never be billed with D16.4
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
D16.4 is named in 15 Medicare coverage policies: 15 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A55315Billing and Coding: Proton Beam Therapy
- A56464Billing and Coding: Flow Cytometry
- A56580Billing and Coding: Computerized Axial Tomography (CT), Thorax
- A56587Billing and Coding: Cosmetic and Reconstructive Surgery
Alphabetic index entries that lead here
- Cyst›calcifying odontogenic›upper jaw(bone) (maxilla)
Code history
Unchanged in every release from FY2024 to FY2027.
Other codes under D16
- D16.0Benign neoplasm of scapula and long bones of upper limb
- D16.1Benign neoplasm of short bones of upper limb
- D16.2Benign neoplasm of long bones of lower limb
- D16.3Benign neoplasm of short bones of lower limb
- D16.5Benign neoplasm of lower jaw bone
- D16.6Benign neoplasm of vertebral column
- D16.7Benign neoplasm of ribs, sternum and clavicle
- D16.8Benign neoplasm of pelvic bones, sacrum and coccyx
- D16.9Benign neoplasm of bone and articular cartilage, unspecified