D35.4
BillableBenign neoplasm of pineal gland
HCC Category Mapping
V28HCC 23 — Melanoma and Other Skin Cancers
0.251V24HCC 12 — Breast, Prostate, and Other Cancers and Tumors
0.150ESRDHCC 12 — Breast, Prostate, and Other Cancers and Tumors
0.000RxHCCHCC 22 — Cancer, Other Specified Sites
0.000What This Code Means
A noncancerous tumor of the pineal gland, a small gland in the center of the brain that produces melatonin.
Coding Tips
- •Pineal gland tumors are uncommon; verify benign histology from pathology report
- •Document any symptoms related to increased intracranial pressure or hormonal effects
Clinical Significance
Benign neoplasm of the pineal gland encompasses tumors such as pineocytomas (WHO Grade I), which arise from the pinealocytes of this midline brain structure responsible for melatonin production. Pineal region tumors can present with obstructive hydrocephalus, Parinaud syndrome (paralysis of upward gaze), and endocrine disturbances. Despite benign histology, their deep central location makes surgical access challenging.
Documentation Requirements
- ✓MRI brain demonstrating a pineal region mass with characteristic features.
- ✓If biopsied or resected, pathology must confirm benign histology (WHO Grade I pineocytoma or other benign pineal tumor).
- ✓Document the presence of hydrocephalus, visual symptoms, and any endocrine abnormalities.
- ✓Tumor markers (AFP, beta-HCG) should be documented to rule out germ cell tumors.
Commonly Confused Codes
D33.0 (benign brain supratentorial) is broader and less specific for pineal locationD35.2 (pituitary) is a different midline glandD43.0 (brain, uncertain behavior) is for tumors with indeterminate gradingC75.3 (malignant pineal) or pineoblastoma (classified under malignant brain tumors) represent malignant pineal neoplasms.
Code Hierarchy
└D35Benign neoplasm of other and unspecified endocrine glands└D35.4Benign neoplasm of pineal gland
└D35.4Benign neoplasm of pineal gland