Is D28.1 a billable ICD-10-CM code?

Yes. D28.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does D28.1 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 D28.1?

D28.1 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 D28.1 (D28) and apply to it just the same.

D28.1

D28.1 — Benign neoplasm of vagina

Billable / specific codeICD-10-CM

D28.1 is a billable, specific ICD-10-CM code for benign neoplasm of vagina. It is valid for submission on a claim.

Excludes1 inherited from the categories above D28.1

These are not written on D28.1, but they bind it: a note on a category applies to every code beneath it. Billing D28.1 with anything listed here is a denial.

Written on D28 — Benign neoplasm of other and unspecified female genital organs

epoophoron cyst (Q50.5)
fimbrial cyst (Q50.4)
Gartner's duct cyst (Q52.4)
parovarian cyst (Q50.5)

Other codes that can never be billed with D28.1

These codes carry an Excludes1 note pointing at D28.1. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading D28.1 alone.

N84Polyp of female genital tract

Risk adjustment

D28.1 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.

Medicare coverage

D28.1 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.

A56580Billing and Coding: Computerized Axial Tomography (CT), Thorax
A56695Billing and Coding: Implantable Infusion Pump
A57044Billing and Coding: Removal of Benign Skin Lesions
A57113Billing and Coding: Removal of Benign Skin Lesions

Code history

D28.1 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 D28. If D28.1 is not quite right, the correct code is usually one of these.

Questions about D28.1

Is D28.1 a billable ICD-10-CM code?: Yes. D28.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does D28.1 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 D28.1?: D28.1 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 D28.1 (D28) and apply to it just the same.