Is D31.22 a billable ICD-10-CM code?

Yes. D31.22 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does D31.22 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 D31.22?

D31.22 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 D31.22 (D31.2, D31) and apply to it just the same.

D31.22

D31.22 — Benign neoplasm of left retina

Billable / specific codeICD-10-CMleft

D31.22 is a billable, specific ICD-10-CM code for benign neoplasm of left retina. It is valid for submission on a claim.

Excludes1 inherited from the categories above D31.22

These are not written on D31.22, but they bind it: a note on a category applies to every code beneath it. Billing D31.22 with anything listed here is a denial.

Written on D31.2 — Benign neoplasm of retina

dark area on retina (D49.81)
hemangioma of retina (D49.81)
neoplasm of unspecified behavior of retina and choroid (D49.81)
retinal freckle (D49.81)

Written on D31 — Benign neoplasm of eye and adnexa

benign neoplasm of connective tissue of eyelid (D21.0)
benign neoplasm of optic nerve (D33.3)
benign neoplasm of skin of eyelid (D22.1-, D23.1-)

Risk adjustment

D31.22 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

D31.22 is named in 19 Medicare coverage policies — 19 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A53060Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
A56464Billing and Coding: Flow Cytometry
A56551Billing and Coding: Visual Fields Testing
A56580Billing and Coding: Computerized Axial Tomography (CT), Thorax

Code history

D31.22 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 D31.2. If D31.22 is not quite right, the correct code is usually one of these.

Questions about D31.22

Is D31.22 a billable ICD-10-CM code?: Yes. D31.22 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does D31.22 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 D31.22?: D31.22 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 D31.22 (D31.2, D31) and apply to it just the same.