Is D21.1 a billable ICD-10-CM code?

No. D21.1 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does D21.1 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 D21.1?

D21.1 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 D21.1 (D21) and apply to it just the same.

D21.1

D21.1 — Benign neoplasm of connective and other soft tissue of upper limb, including shoulder

Non-billable headerICD-10-CM

D21.1 is a non-billable header ICD-10-CM code for benign neoplasm of connective and other soft tissue of upper limb, including shoulder. It cannot be billed on its own: choose one of the more specific child codes below.

Excludes1 inherited from the categories above D21.1

These are not written on D21.1, but they bind it: a note on a category applies to every code beneath it. Billing D21.1 with anything listed here is a denial.

Written on D21 — Other benign neoplasms of connective and other soft tissue

benign neoplasm of articular cartilage (D16.-)
benign neoplasm of cartilage of larynx (D14.1)
benign neoplasm of cartilage of nose (D14.0)
benign neoplasm of connective tissue of breast (D24.-)
benign neoplasm of peripheral nerves and autonomic nervous system (D36.1-)
benign neoplasm of peritoneum (D20.1)
benign neoplasm of retroperitoneum (D20.0)
benign neoplasm of uterine ligament, any (D28.2)
benign neoplasm of vascular tissue (D18.-)
hemangioma (D18.0-)
lipomatous neoplasm (D17.-)
lymphangioma (D18.1)
uterine leiomyoma (D25.-)

Other codes that can never be billed with D21.1

These codes carry an Excludes1 note pointing at D21.1. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading D21.1 alone.

D16Benign neoplasm of bone and articular cartilage

Risk adjustment

D21.1 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.

Code history

D21.1 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Code to one of these instead D21.1

3 child codes. Green means billable.

Related codes at this level

Codes that share D21. If D21.1 is not quite right, the correct code is usually one of these.

Questions about D21.1

Is D21.1 a billable ICD-10-CM code?: No. D21.1 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does D21.1 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 D21.1?: D21.1 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 D21.1 (D21) and apply to it just the same.