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

ICD-10 D31.20

Billable / Specific

Benign neoplasm of unspecified retina

D31
Block
0
Synonyms
26
LCDs
5
Payer Policies
5
Linked CPTs

About ICD-10-CM D31.20

ICD-10-CM code D31.20 represents Benign neoplasm of unspecified retina. This is a billable/specific code in the Neoplasms chapter (block D31). The 2026 edition of ICD-10-CM D31.20 became effective on October 1, 2025.

Medicare LCD Coverage for D31.20

Local Coverage Determinations (LCDs) from CMS MACs that list D31.20 as a covered diagnosis.

26 LCDs

Showing top 10 of 26 total . Click a CPT for full coverage scope.

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 →
CMS LCD: Billing and Coding: Peripheral Nerve Blocks
Article ID: 57788, Effective: 2025-10-30 00:00:00, 1815 covered, 1 non-covered
CPT 64450 →
CMS LCD: Billing and Coding: Peripheral Nerve Blocks
Article ID: 57788, Effective: 2025-10-30 00:00:00, 1815 covered, 1 non-covered
CPT 64446 →
CMS LCD: Billing and Coding: Peripheral Nerve Blocks
Article ID: 57788, Effective: 2025-10-30 00:00:00, 1815 covered, 1 non-covered
CPT 64455 →
CMS LCD: Billing and Coding: Peripheral Nerve Blocks
Article ID: 57788, Effective: 2025-10-30 00:00:00, 1815 covered, 1 non-covered
CPT 64417 →
CMS LCD: Billing and Coding: Peripheral Nerve Blocks
Article ID: 57788, Effective: 2025-10-30 00:00:00, 1815 covered, 1 non-covered
CPT 64447 →
CMS LCD: Billing and Coding: Peripheral Nerve Blocks
Article ID: 57788, Effective: 2025-10-30 00:00:00, 1815 covered, 1 non-covered
CPT 64449 →
CMS LCD: Billing and Coding: Peripheral Nerve Blocks
Article ID: 57788, Effective: 2025-10-30 00:00:00, 1815 covered, 1 non-covered
CPT 64448 →
CMS LCD: Billing and Coding: Peripheral Nerve Blocks
Article ID: 57788, Effective: 2025-10-30 00:00:00, 1815 covered, 1 non-covered
CPT 64445 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing D31.20.

5 policies

3 Medicare

Billing and Coding: Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy and Fundus Photography)
Policy ID: ART-57071
Billing and Coding: Visual Field Examination
Policy ID: ART-57637
Billing and Coding: Peripheral Nerve Blocks
Policy ID: ART-57788

2 Aetna

Optic Nerve and Retinal Imaging Methods
Policy ID: CPB-0344
Fundus Photography
Policy ID: CPB-0539

CPT Codes Commonly Billed with D31.20

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

5 linkages
  • 92228 CMS LCD: Billing and Coding: Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy and Fundus Photography) CMS LCD
  • 92201 CMS LCD: Billing and Coding: Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy and Fundus Photography) CMS LCD
  • 92202 CMS LCD: Billing and Coding: Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy and Fundus Photography) CMS LCD
  • 92250 CMS LCD: Billing and Coding: Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy and Fundus Photography) CMS LCD
  • 92227 CMS LCD: Billing and Coding: Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy and Fundus Photography) CMS LCD

Convert D31.20 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
D31.20 2245 10000

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

ICD-10 D31.20, Billing FAQ

Is ICD-10 code D31.20 billable? +

Yes, D31.20 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 D31.20? +

Procedures frequently paired with D31.20 include: 92228, 92201, 92202, 92250, 92227.

What ICD-9 codes does D31.20 map to? +

Per CMS GEMs, D31.20 maps to ICD-9 codes: 2245. 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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