ICD-10 code D27.0: Benign neoplasm of right ovary

Key Takeaways

D27.0 is a billable ICD-10-CM code for benign neoplasm of the right ovary, valid for the 2026 code set.

Always specify laterality: D27.0 (right), D27.1 (left), or D27.9 (unspecified) since the parent code D27 is non-billable.

Seven conditions are excluded via Type 2 Excludes notes, including functional ovarian cysts (N83.x) and endometrial cysts (N80.1).

Pabau’s claims management software helps gynecology practices attach the correct D27.x code to claims and reduce denial rates.

ICD-10 code D27.0 is the billable diagnosis code for a benign neoplasm of the right ovary. It sits within ICD-10-CM Chapter C00-D49 (Neoplasms) and the more specific block D10-D36 (Benign neoplasms, except benign neuroendocrine tumors). The code is maintained jointly by the Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS), and is valid for FY 2026 encounters.

ICD-10 code D27.0: Definition and clinical description

Clinically, D27.0 captures a range of benign ovarian growths confirmed as neoplastic in nature. It does not apply to functional cysts, retention cysts, or endometriosis-related cysts, which each carry their own codes. The distinction matters: a follicular cyst (N83.0) and an ovarian cystadenoma (D27.0) may look similar on imaging but require completely different codes at billing.

Using the parent code D27 instead of the laterality-specific child codes results in a claim that payers reject outright, because D27 is non-billable. OB/GYN practice management software that supports structured ICD-10 entry can catch this at the point of charge capture, before the claim ever leaves the practice.

Billable status and code hierarchy for ICD-10 code D27.0

D27.0 is a valid, billable ICD-10-CM code for the 2026 code set. Its parent, D27 (Benign neoplasm of ovary), is non-billable and cannot be submitted on a claim. Payers require the full laterality specification before adjudicating.

Always assign D27.0 or D27.1 when the operative or pathology report specifies a side. Use D27.9 only when the laterality is genuinely unknown after reviewing all available documentation. Defaulting to D27.9 because it is easier to remember is a common coding shortcut that auditors flag during documentation reviews. Applying the same specificity discipline used when coding other benign neoplasms reinforces why specificity at the sub-code level is non-negotiable.

Per the D27 parent code instructions in the AAPC Codify ICD-10-CM lookup, an additional code may be assigned to identify any associated functional activity. This is relevant when a benign ovarian neoplasm produces hormones affecting other organ systems.

Synonyms and inclusion terms for D27.0

Several clinical terms map to ICD-10 code D27.0. Knowing these synonyms prevents under-coding when a pathology report uses terminology that differs from the code’s official description.

• Ovarian cystadenoma (right) – a common benign epithelial tumor of the ovary; serous and mucinous subtypes both code to D27.0 when right-sided
• Benign germ cell tumor of ovary (right) – includes mature cystic teratomas (dermoid cysts) of the right ovary
• Benign Brenner tumor of ovary – a transitional cell tumor; the right-sided variant codes to D27.0
• Benign neoplasm of right ovary NOS – used when pathology confirms benign character but does not specify a histological type

Benign germ cell tumor of ovary is a recognized synonym for D27.0. Note that atypical Meigs syndrome and Brenner tumor NOS are associated with D27.9 (unspecified) rather than D27.0, so laterality documentation is needed to move those diagnoses to the correct code.

Type 2 Excludes notes: What D27.0 does not cover

The D27 parent code carries seven Type 2 Excludes notes. A Type 2 Excludes note signals that the excluded condition is separate from the code in question, but a patient can carry both diagnoses simultaneously. Neither code subsumes the other.

The practical takeaway: D27.0 requires pathological or imaging-confirmed neoplastic tissue. If the clinical note describes a simple cyst with no histological confirmation of neoplasm, the N83.x family is the correct starting point. Mixing up N83.x and D27.x is one of the top denial triggers for gynecology claims in outpatient settings. The same distinction applies when coding a mass versus a simple cyst in other organs.

ICD-10 code D27.0 vs D27.1 vs D27.9: Choosing the right code

Laterality is the deciding factor. When operative notes, imaging reports, or pathology confirm which ovary is affected, that side determines the code. The decision tree is straightforward once documentation is reviewed:

1. Right ovary confirmed – assign D27.0
2. Left ovary confirmed – assign D27.1
3. Side not documented or genuinely unknown after full record review – assign D27.9
4. Bilateral involvement – assign both D27.0 and D27.1; do not use D27.9 when both sides are documented

Coders should query the provider when operative notes reference only “the ovary” without side specification. Most payers treat D27.9 as a red flag during automated claim edits, particularly for surgical claims involving CPT codes such as 58661 (laparoscopy with removal of adnexal structures) or 58720 (salpingo-oophorectomy). Related gynecologic procedures such as salpingectomy and laparoscopic hysterectomy carry their own CPT coding rules. A laterality-specific code on the claim reduces the probability of a medical necessity denial.

Code sequencing also matters when D27.0 appears alongside other diagnoses, such as a routine gynecological examination code. The neoplasm code is typically the principal diagnosis when the surgical procedure is performed for definitive management of the mass.

ICD-9-CM crosswalk for ICD-10 code D27.0

Claims data predating the October 2015 ICD-10-CM transition used ICD-9-CM code 220 (Benign neoplasm of ovary). ICD-10-CM code D27.0 converts approximately from ICD-9-CM 220 per the CDC/NCHS ICD-10-CM web tool. The crosswalk is approximate rather than exact because ICD-9 code 220 did not capture laterality. A single ICD-9 code maps to three ICD-10 child codes (D27.0, D27.1, D27.9) depending on documentation specificity.

When researching historical claims or conducting retrospective audits, verify approximate equivalencies against an ICD-9 to ICD-10 crosswalk, and remember that crosswalk tools provide guidance, not official coding authority. The CDC/NCHS ICD-10-CM files remain the authoritative reference for code definitions and hierarchical context.

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Clinical documentation requirements for D27.0

Three documentation elements must be present before a coder assigns ICD-10 code D27.0. Missing any one of them creates audit vulnerability and risks claim denial or recoupment.

• Laterality confirmation – the operative report, radiology read, or pathology report must explicitly state “right ovary.” Coders cannot infer laterality from anatomy or procedure approach alone.
• Neoplasm confirmation – pathology or a treating clinician must document the mass as a neoplasm (not simply a cyst). Imaging alone is insufficient for most payers when a definitive tissue diagnosis is available.
• Benign characterization – the pathology report must confirm benign histology. If malignancy has not been excluded, the appropriate malignant ovarian code (C56.x) may apply instead.

Using clinical documentation tools that structure operative and pathology notes helps ensure laterality and histological findings are captured consistently. Practices comparing gynecology EHR platforms should prioritize structured ICD-10 entry. Those that rely on HIPAA-compliant diagnosis documentation workflows can build laterality fields directly into pre-operative intake templates, removing the guesswork at coding time.

Common documentation errors that trigger denials

Operative notes that say “left adnexa resected” without specifying ovary versus tube create ambiguity. Pathology reports that use shorthand like “right adnexal mass – benign” without a histological subtype still support D27.0, but more specific reports strengthen the coding position. Encourage providers to include the affected structure (ovary), the side, and the histological characterization in every relevant operative dictation.

Attaching digital intake forms that prompt for laterality at the pre-operative consultation stage moves the documentation burden earlier in the care pathway, where it is easier to capture accurately.

Common co-diagnosis codes used with D27.0

D27.0 rarely appears in isolation on a surgical claim. Practices managing fertility clinic and general gynecology caseloads should anticipate these secondary codes:

• N80.101 (Endometriosis of right ovary) – when endometriosis coexists with a confirmed benign neoplasm; the Type 2 Excludes note permits both codes together. N80.1 is a non-billable category, so assign the specific N80.10x or N80.11x code
• Z01.411 / Z01.419 (Encounter for gynecological examination) – when the neoplasm is an incidental finding during a routine examination
• Z80.41 (Family history of ovarian cancer) – relevant for patients with hereditary risk documented in the record
• N94.x (Pain and other conditions associated with female genital organs) – when pelvic pain is a co-presenting symptom alongside the confirmed neoplasm

Sequencing matters. When the surgical procedure is performed specifically for D27.0, the neoplasm code is the principal diagnosis. Secondary diagnoses follow clinical coding guidelines for sequencing. Medical billing software that supports multi-code claim builds with sequencing logic reduces the risk of payer edits flagging incorrect principal-secondary ordering.

AI-assisted documentation for coding accuracy

Laterality errors in gynecology coding often trace back to documentation habits rather than coder knowledge. When operative notes are dictated quickly after surgery, key details like side specification get dropped. AI-assisted clinical documentation tools that listen during or after procedures can prompt providers to confirm laterality before the note is finalized, creating cleaner source documentation for coders.

Practices using clinical documentation software and AI note-generation for gynecology procedures see fewer missing-laterality queries at coding time. The downstream effect is fewer pended claims and faster reimbursement cycles for D27.x surgical encounters.

Conclusion

ICD-10 code D27.0 is straightforward once coders understand its two core requirements: confirmed neoplastic tissue and documented right-sided laterality. The common failure points are using the non-billable parent code D27, conflating functional cysts (N83.x) with confirmed neoplasms, and defaulting to D27.9 when laterality is actually documented elsewhere in the record.

Gynecology and women’s health practices that build laterality prompts into their pre-operative and documentation workflows will find D27.0 coding straightforward and denial rates low. Pabau’s claims management software supports structured ICD-10 code assignment, helping practices reduce claim errors and improve reimbursement speed. To see how it works in a gynecology context, book a demo.

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