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

ICD-10 D31.6

Non-Billable Header

Benign neoplasm of unspecified site of orbit

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

About ICD-10-CM D31.6

ICD-10-CM code D31.6 represents Benign neoplasm of unspecified site of orbit. This is a non-billable header code in the Neoplasms chapter (block D31). The 2026 edition of ICD-10-CM D31.6 became effective on October 1, 2025. Non-billable codes cannot be used as a primary or secondary diagnosis on a claim, use a more specific child code instead.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under D31.6. Per CMS ICD-10-CM Tabular 2026.

  • Benign neoplasm of connective tissue of orbit
  • Benign neoplasm of extraocular muscle
  • Benign neoplasm of peripheral nerves of orbit
  • Benign neoplasm of retrobulbar tissue
  • Benign neoplasm of retro-ocular tissue

Type 1 Excludes

Pure excludes, these codes can never be coded together with D31.6. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • benign neoplasm of orbital bone (D16.4)

Medicare LCD Coverage for D31.6

Local Coverage Determinations (LCDs) from CMS MACs that list D31.6 as a covered diagnosis.

No Medicare LCDs reference D31.6 as covered

This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.

Commercial Payer Coverage

Coverage policies from major commercial payers referencing D31.6.

No commercial payer policies reference D31.6 on file

Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but D31.6 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.

CPT Codes Commonly Billed with D31.6

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

No procedure linkages on file for D31.6

We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.

ICD-10 D31.6, Billing FAQ

Is ICD-10 code D31.6 billable? +

No, D31.6 is a non-billable header code. Use a more specific child code from block D31 when submitting claims.

What other names or terms map to D31.6? +

ICD-10 D31.6 includes: Benign neoplasm of connective tissue of orbit; Benign neoplasm of extraocular muscle; Benign neoplasm of peripheral nerves of orbit, and 2 more clinical synonyms.

What codes are Type 1 Excludes for D31.6? +

Type 1 Excludes (never code together with D31.6): benign neoplasm of orbital bone (D16.4)

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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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