D33.4

Billable

Benign neoplasm of spinal cord

HCC Category Mapping

V28HCC 23 — Melanoma and Other Skin Cancers

0.251

V24HCC 12 — Breast, Prostate, and Other Cancers and Tumors

0.150

ESRDHCC 12 — Breast, Prostate, and Other Cancers and Tumors

0.000

RxHCCHCC 22 — Cancer, Other Specified Sites

0.000

What This Code Means

A non-cancerous tumor that grows within or on the spinal cord itself.

Coding Tips

•Distinguish between spinal cord tumors (D33.4) and spinal meningeal tumors (D32.1)
•Document the level of spinal cord involvement (cervical, thoracic, lumbar) for comprehensive clinical documentation

Clinical Significance

Benign neoplasm of the spinal cord represents intramedullary tumors, most commonly ependymomas and astrocytomas, that arise within the spinal cord parenchyma itself. These tumors can cause progressive myelopathy, sensory loss, weakness, and bowel/bladder dysfunction. Despite their benign histology, surgical resection can be challenging due to the eloquent nature of the spinal cord tissue.

Documentation Requirements

✓MRI of the spine documenting an intramedullary lesion is required.
✓Specify the spinal level (cervical, thoracic, lumbar, conus medullaris), tumor dimensions, and any associated syringomyelia.
✓Pathology from biopsy or resection should confirm benign WHO grade.
✓Document neurological examination findings, functional status, and treatment plan.

Commonly Confused Codes

D32.1 (benign neoplasm of spinal meninges) is for intradural-extramedullary tumors, not intramedullary D33.3 (cranial nerves) is for intracranial nerve tumors D36.10 (peripheral nerve neoplasm) is for tumors of spinal nerve roots outside the cord D43.4 (spinal cord, uncertain behavior) is for tumors with indeterminate biology.

Code Hierarchy

└D33Benign neoplasm of brain and other parts of central nervous system └D33.4Benign neoplasm of spinal cord

└D33.4Benign neoplasm of spinal cord