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

ICD-10 D16.20

Billable / Specific

Benign neoplasm of long bones of unspecified lower limb

D16
Block
0
Synonyms
34
LCDs
3
Payer Policies
6
Linked CPTs

About ICD-10-CM D16.20

ICD-10-CM code D16.20 represents Benign neoplasm of long bones of unspecified lower limb. This is a billable/specific code in the Neoplasms chapter (block D16). The 2026 edition of ICD-10-CM D16.20 became effective on October 1, 2025.

Medicare LCD Coverage for D16.20

Local Coverage Determinations (LCDs) from CMS MACs that list D16.20 as a covered diagnosis.

34 LCDs

Showing top 10 of 34 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Lower Extremity Major Joint Replacement (Hip and Knee)
Article ID: 56796, Effective: 2026-01-01 00:00:00, 1355 covered, 1 non-covered
CPT 27134 →
CMS LCD: Billing and Coding: Lower Extremity Major Joint Replacement (Hip and Knee)
Article ID: 56796, Effective: 2026-01-01 00:00:00, 1355 covered, 1 non-covered
CPT 27130 →
CMS LCD: Billing and Coding: Lower Extremity Major Joint Replacement (Hip and Knee)
Article ID: 56796, Effective: 2026-01-01 00:00:00, 1355 covered, 1 non-covered
CPT 27487 →
CMS LCD: Billing and Coding: Lower Extremity Major Joint Replacement (Hip and Knee)
Article ID: 56796, Effective: 2026-01-01 00:00:00, 1355 covered, 1 non-covered
CPT 27137 →
CMS LCD: Billing and Coding: Lower Extremity Major Joint Replacement (Hip and Knee)
Article ID: 56796, Effective: 2026-01-01 00:00:00, 1355 covered, 1 non-covered
CPT 27486 →
CMS LCD: Billing and Coding: Lower Extremity Major Joint Replacement (Hip and Knee)
Article ID: 56796, Effective: 2026-01-01 00:00:00, 1355 covered, 1 non-covered
CPT 27138 →
CMS LCD: Billing and Coding: Lower Extremity Major Joint Replacement (Hip and Knee)
Article ID: 56796, Effective: 2026-01-01 00:00:00, 1355 covered, 1 non-covered
CPT 27132 →
CMS LCD: Billing and Coding: Lower Extremity Major Joint Replacement (Hip and Knee)
Article ID: 56796, Effective: 2026-01-01 00:00:00, 1355 covered, 1 non-covered
CPT 27447 →
CMS LCD: Billing and Coding: Peripheral Nerve Blocks
Article ID: 57788, Effective: 2025-10-30 00:00:00, 1815 covered, 1 non-covered
CPT 64420 →
CMS LCD: Billing and Coding: Peripheral Nerve Blocks
Article ID: 57788, Effective: 2025-10-30 00:00:00, 1815 covered, 1 non-covered
CPT 64425 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing D16.20.

3 policies

3 Medicare

Billing and Coding: Lower Extremity Major Joint Replacement (Hip and Knee)
Policy ID: ART-56796
Billing and Coding: Major Joint Replacement (Hip and Knee)
Policy ID: ART-57765
Billing and Coding: Peripheral Nerve Blocks
Policy ID: ART-57788

CPT Codes Commonly Billed with D16.20

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

6 linkages
  • 27134 CMS LCD: Billing and Coding: Major Joint Replacement (Hip and Knee) CMS LCD
  • 27132 CMS LCD: Billing and Coding: Major Joint Replacement (Hip and Knee) CMS LCD
  • 27138 CMS LCD: Billing and Coding: Major Joint Replacement (Hip and Knee) CMS LCD
  • 27137 CMS LCD: Billing and Coding: Major Joint Replacement (Hip and Knee) CMS LCD
  • 27487 CMS LCD: Billing and Coding: Major Joint Replacement (Hip and Knee) CMS LCD
  • 27486 CMS LCD: Billing and Coding: Major Joint Replacement (Hip and Knee) CMS LCD

Convert D16.20 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
D16.20 2137 10000

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

Codes Adjacent To D16.20

Other codes in section D10-D36 (Benign neoplasms, except benign neuroendocrine tumors).

D10 Benign neoplasm of mouth and pharynx (non-billable) D10.0 Benign neoplasm of lip D10.1 Benign neoplasm of tongue D10.2 Benign neoplasm of floor of mouth D10.3 Benign neoplasm of other and unspecified parts of mouth (non-billable) D10.30 Benign neoplasm of unspecified part of mouth D10.39 Benign neoplasm of other parts of mouth D10.4 Benign neoplasm of tonsil D10.5 Benign neoplasm of other parts of oropharynx D10.6 Benign neoplasm of nasopharynx D10.7 Benign neoplasm of hypopharynx D10.9 Benign neoplasm of pharynx, unspecified D11 Benign neoplasm of major salivary glands (non-billable) D11.0 Benign neoplasm of parotid gland D11.7 Benign neoplasm of other major salivary glands D11.9 Benign neoplasm of major salivary gland, unspecified D12 Benign neoplasm of colon, rectum, anus and anal canal (non-billable) D12.0 Benign neoplasm of cecum D12.1 Benign neoplasm of appendix D12.2 Benign neoplasm of ascending colon

ICD-10 D16.20, Billing FAQ

Is ICD-10 code D16.20 billable? +

Yes, D16.20 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What CPT codes are commonly billed with D16.20? +

Procedures frequently paired with D16.20 include: 27134, 27132, 27138, 27137, 27487.

What ICD-9 codes does D16.20 map to? +

Per CMS GEMs, D16.20 maps to ICD-9 codes: 2137. 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 September 1, 2026.

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