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

ICD-10 D29.1

Billable / Specific

Benign neoplasm of prostate

D29
Block
0
Synonyms
181
LCDs
15
Payer Policies
13
Linked CPTs

About ICD-10-CM D29.1

ICD-10-CM code D29.1 represents Benign neoplasm of prostate. This is a billable/specific code in the Neoplasms chapter (block D29). The 2026 edition of ICD-10-CM D29.1 became effective on October 1, 2025.

Type 1 Excludes

Pure excludes, these codes can never be coded together with D29.1. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • enlarged prostate (N40.-)

Medicare LCD Coverage for D29.1

Local Coverage Determinations (LCDs) from CMS MACs that list D29.1 as a covered diagnosis.

181 LCDs

Showing top 10 of 181 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Transrectal Ultrasound
Article ID: 57427, Effective: 2024-10-01 00:00:00, 118 covered, 0 non-covered
CPT 76872 →
CMS LCD: Billing and Coding: Transrectal Ultrasound
Article ID: 57427, Effective: 2024-10-01 00:00:00, 118 covered, 0 non-covered
CPT 76873 →
CMS LCD: Billing and Coding: MolDX: Molecular Biomarkers to Risk-Stratify Patients at Increased Risk for Prostate Cancer
Article ID: 58759, Effective: 2025-01-30 00:00:00, 5 covered, 0 non-covered
CPT 81479 →
CMS LCD: Billing and Coding: MolDX: Molecular Biomarkers to Risk-Stratify Patients at Increased Risk for Prostate Cancer
Article ID: 58759, Effective: 2025-01-30 00:00:00, 5 covered, 0 non-covered
CPT 81313 →
CMS LCD: Billing and Coding: MolDX: Molecular Biomarkers to Risk-Stratify Patients at Increased Risk for Prostate Cancer
Article ID: 58759, Effective: 2025-01-30 00:00:00, 5 covered, 0 non-covered
CPT 0339U →
CMS LCD: Billing and Coding: MolDX: Molecular Biomarkers to Risk-Stratify Patients at Increased Risk for Prostate Cancer
Article ID: 58759, Effective: 2025-01-30 00:00:00, 5 covered, 0 non-covered
CPT 0403U →
CMS LCD: Billing and Coding: MolDX: Molecular Biomarkers to Risk-Stratify Patients at Increased Risk for Prostate Cancer
Article ID: 58759, Effective: 2025-01-30 00:00:00, 5 covered, 0 non-covered
CPT 81551 →
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 →
CMS LCD: Billing and Coding: Peripheral Nerve Blocks
Article ID: 57452, Effective: 2025-10-01 00:00:00, 1570 covered, 0 non-covered
CPT 20561 →
CMS LCD: Billing and Coding: Peripheral Nerve Blocks
Article ID: 57452, Effective: 2025-10-01 00:00:00, 1570 covered, 0 non-covered
CPT 64415 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing D29.1.

15 policies

2 Aetna

Transrectal Ultrasound - Medical Clinical Policy Bulletins | Aetna
Policy ID: CPB-0001
Prostate Cancer Screening
Policy ID: CPB-0521

5 Medicare

Billing and Coding: Biomarkers for Oncology
Policy ID: ART-52986
Billing and Coding: Laser Ablation of the Prostate
Policy ID: ART-56467
Billing and Coding: Computerized Axial Tomography (CT), Thorax
Policy ID: ART-56580
Billing and Coding: Implantable Infusion Pump
Policy ID: ART-56695
Billing and Coding: Urodynamics
Policy ID: ART-56802

CPT Codes Commonly Billed with D29.1

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

13 linkages
  • 52649 CMS LCD: Billing and Coding: Laser Ablation of the Prostate CMS LCD
  • 52648 CMS LCD: Billing and Coding: Laser Ablation of the Prostate CMS LCD
  • 51741 CMS LCD: Billing and Coding: Urodynamics CMS LCD
  • 51728 CMS LCD: Billing and Coding: Urodynamics CMS LCD
  • 51729 CMS LCD: Billing and Coding: Urodynamics CMS LCD
  • 55899 CMS LCD: Billing and Coding: Urodynamics CMS LCD
  • 51792 CMS LCD: Billing and Coding: Urodynamics CMS LCD
  • 51736 CMS LCD: Billing and Coding: Urodynamics CMS LCD
  • 51726 CMS LCD: Billing and Coding: Urodynamics CMS LCD
  • 51727 CMS LCD: Billing and Coding: Urodynamics CMS LCD

Convert D29.1 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
D29.1 2222 00000

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

ICD-10 D29.1, Billing FAQ

Is ICD-10 code D29.1 billable? +

Yes, D29.1 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 D29.1? +

Type 1 Excludes (never code together with D29.1): enlarged prostate (N40.-)

What CPT codes are commonly billed with D29.1? +

Procedures frequently paired with D29.1 include: 52649, 52648, 51741, 51728, 51729.

What ICD-9 codes does D29.1 map to? +

Per CMS GEMs, D29.1 maps to ICD-9 codes: 2222. 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 June 1, 2026.

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