Is D21.5 a billable ICD-10-CM code?

Yes. D21.5 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does D21.5 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 D21.5?

D21.5 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

D21.5

D21.5 — Benign neoplasm of connective and other soft tissue of pelvis

Billable / specific codeICD-10-CM

D21.5 is a billable, specific ICD-10-CM code for benign neoplasm of connective and other soft tissue of pelvis. 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.

benign neoplasm of any uterine ligament (D28.2)
uterine leiomyoma (D25.-)

Risk adjustment

D21.5 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

D21.5 is named in 9 Medicare coverage policies — 9 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A56346Billing and Coding: Removal of Benign and Malignant Skin Lesions
A56421Billing and Coding: CT of the Abdomen and Pelvis
A56580Billing and Coding: Computerized Axial Tomography (CT), Thorax
A56695Billing and Coding: Implantable Infusion Pump

Related codes at this level

Codes that share D21. If D21.5 is not quite right, the correct code is usually one of these.

Questions about D21.5

Is D21.5 a billable ICD-10-CM code?: Yes. D21.5 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does D21.5 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 D21.5?: D21.5 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.