ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 D13.1

Billable / Specific

Benign neoplasm of stomach

D13
Block
0
Synonyms
237
LCDs
12
Payer Policies
1
Linked CPTs

About ICD-10-CM D13.1

ICD-10-CM code D13.1 represents Benign neoplasm of stomach. This is a billable/specific code in the Neoplasms chapter (block D13). The 2026 edition of ICD-10-CM D13.1 became effective on October 1, 2025.

Type 1 Excludes

Pure excludes, these codes can never be coded together with D13.1. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • benign carcinoid tumor of the stomach (D3A.092)

Medicare LCD Coverage for D13.1

Local Coverage Determinations (LCDs) from CMS MACs that list D13.1 as a covered diagnosis.

237 LCDs

Showing top 10 of 237 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74170 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74177 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74160 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74178 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74150 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 72194 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74176 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 72192 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 72193 →
CMS LCD: Billing and Coding: Peripheral Nerve Blocks
Article ID: 57452, Effective: 2025-10-01 00:00:00, 1570 covered, 0 non-covered
CPT 64420 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing D13.1.

12 policies

1 Cigna

Vitamin D Testing - (0526) ---- future effective policy
Policy ID: MM_0526

5 Medicare

Oral Anticancer Drugs - Policy Article
Policy ID: ART-52479
Billing and Coding: Upper Gastrointestinal Endoscopy and Visualization
Policy ID: ART-56389
Billing and Coding: CT of the Abdomen and Pelvis
Policy ID: ART-56421
Billing and Coding: Computerized Axial Tomography (CT), Thorax
Policy ID: ART-56580
Billing and Coding: Implantable Infusion Pump
Policy ID: ART-56695

1 Aetna

Helicobacter Pylori Infection Testing
Policy ID: CPB-0177

CPT Codes Commonly Billed with D13.1

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

1 linkages
  • 43249 EGD with dilation — Barrett esophagus, esophageal stricture, esophageal web, gastric outlet obstruction, esophageal polyp, gastric polyp Gastroenterology

Convert D13.1 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
D13.1 2111 10000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 D13.1, Billing FAQ

Is ICD-10 code D13.1 billable? +

Yes, D13.1 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What codes are Type 1 Excludes for D13.1? +

Type 1 Excludes (never code together with D13.1): benign carcinoid tumor of the stomach (D3A.092)

What CPT codes are commonly billed with D13.1? +

Procedures frequently paired with D13.1 include: 43249.

What ICD-9 codes does D13.1 map to? +

Per CMS GEMs, D13.1 maps to ICD-9 codes: 2111. Useful for legacy data review and historical claim analysis.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on May 31, 2026.

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