D44.5
BillableNeoplasm of uncertain behavior 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 tumor of the pineal gland (a small gland in the brain) that cannot yet be classified as definitely benign or malignant.
Coding Tips
- •Document any hormonal symptoms or melatonin-related findings if present
- •Ensure pathology report confirms uncertain behavior classification before coding
Clinical Significance
Neoplasms of uncertain behavior of the pineal gland include tumors such as pineocytomas with atypical features or pineal parenchymal tumors of intermediate differentiation. These tumors can cause obstructive hydrocephalus by compressing the cerebral aqueduct and may present with Parinaud syndrome (upgaze paralysis) due to tectal compression.
Documentation Requirements
- ✓Documentation must specify the pineal gland location, supported by brain magnetic resonance imaging showing a pineal region mass.
- ✓Pathology should describe histological features supporting uncertain behavior.
- ✓Document any signs of obstructive hydrocephalus, visual symptoms, or endocrine disturbances (precocious puberty in children).
Commonly Confused Codes
D35.4 (benign neoplasm of pineal gland) is used for confirmed benign pineal tumors such as typical pineocytomas.C75.3 (malignant neoplasm of pineal gland) is used for pineoblastomas and malignant pineal tumors.D43.1 (uncertain behavior of infratentorial brain) may be confused if the pineal tumor is not correctly localized.
Code Hierarchy
└D44Neoplasm of uncertain behavior of endocrine glands└D44.5Neoplasm of uncertain behavior of pineal gland
└D44.5Neoplasm of uncertain behavior of pineal gland