D13.7: Benign neoplasm of endocrine pancreas
D13.7, benign neoplasm of endocrine pancreas, is listed as a covered diagnosis in 3 Medicare billing and coding articles that apply to 11 HCPCS Level II codes, including J2353 (Injection, octreotide, depot form for intramuscular…), J0585 (Injection, onabotulinumtoxina, 1 unit), E0783 (Infusion pump system, implantable, programmable (includes…). 4 of these codes have a 2026 DMEPOS fee schedule amount; E0783 pays $9,917.33 to $11,667.45 (NU) depending on the state. The articles come from 1 Medicare contractor. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.
HCPCS Level II codes with D13.7 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| J2353 | Injection, octreotide, depot form for intramuscular injection, 1 mg | Carrier judgment | — | 1 |
| J0585 | Injection, onabotulinumtoxina, 1 unit | Special coverage instructions apply | — | 1 |
| E0783 | Infusion pump system, implantable, programmable (includes all components, e.g., pump, catheter, connectors, etc.) | Special coverage instructions apply | $9,917.33–$11,667.45 (NU) | 1 |
| E0786 | Implantable programmable infusion pump, replacement (excludes implantable intraspinal catheter) | Special coverage instructions apply | $10,969.75–$11,380.88 (NU) | 1 |
| E0782 | Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.) | Special coverage instructions apply | $5,200.92–$6,118.73 (NU) | 1 |
| E0785 | Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement | Special coverage instructions apply | $572.38–$673.39 (KF) | 1 |
| J7999 | Compounded drug, not otherwise classified | Special coverage instructions apply | — | 1 |
| J2278 | Injection, ziconotide, 1 microgram | Special coverage instructions apply | — | 1 |
| J2274 | Injection, morphine sulfate, preservative-free for epidural or intrathecal use, 10 mg | Special coverage instructions apply | — | 1 |
| A4220 | Refill kit for implantable infusion pump | Special coverage instructions apply | — | 1 |
| J9200 | Injection, floxuridine, 500 mg | Special coverage instructions apply | — | 1 |
Medicare policy articles listing D13.7
- A56531: Billing and Coding: Octreotide Acetate for Injectable Suspension (Sandostatin® LAR Depot) (Palmetto GBA (MAC - Part B); 1 Level II codes). LCD with the same title: L33438
- A56389: Billing and Coding: Upper Gastrointestinal Endoscopy and Visualization (Palmetto GBA (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L34434
- A56695: Billing and Coding: Implantable Infusion Pump (Palmetto GBA (MAC - Part B); 9 Level II codes). LCD with the same title: L33461
A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.
Other D13 diagnoses (Benign neoplasm of other and ill-defined parts of digestive system)
- D13.1 — Benign neoplasm of stomach
- D13.2 — Benign neoplasm of duodenum
- D13.39 — Benign neoplasm of other parts of small intestine
Frequently asked questions
Does Medicare cover D13.7 (Benign neoplasm of endocrine pancreas)?
Medicare covers items and services, not diagnoses. 3 Medicare billing and coding articles list D13.7 as a covered diagnosis for 11 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.
Which HCPCS codes can be billed with ICD-10 D13.7?
The Level II codes from the policies most specific to this diagnosis are J2353 (Injection, octreotide, depot form for intramuscular…, 1 article); J0585 (Injection, onabotulinumtoxina, 1 unit, 1 article); E0783 (Infusion pump system, implantable, programmable (includes…, 1 article); E0786 (Implantable programmable infusion pump, replacement…, 1 article); E0782 (Infusion pump, implantable, non-programmable (includes all…, 1 article). Code choice depends on the item supplied; check each code's descriptor.
What does Medicare pay for equipment billed with D13.7?
Under the 2026 DMEPOS fee schedule (non-rural state fees): E0783 $9,917.33 to $11,667.45 (NU); E0786 $10,969.75 to $11,380.88 (NU); E0782 $5,200.92 to $6,118.73 (NU); E0785 $572.38 to $673.39 (KF). Medicare pays 80% of the allowed amount after the Part B deductible.
Which Medicare policy articles list D13.7?
A56531 (Billing and Coding: Octreotide Acetate for Injectable Suspension (Sandostatin® LAR Depot)); A56389 (Billing and Coding: Upper Gastrointestinal Endoscopy and Visualization); A56695 (Billing and Coding: Implantable Infusion Pump).
What is ICD-10-CM code D13.7?
D13.7 is the ICD-10-CM code for benign neoplasm of endocrine pancreas, in category D13 (Benign neoplasm of other and ill-defined parts of digestive system), chapter 2: Neoplasms.
Next steps
- Run a reimbursement report for a device billed under J2353
- Watch J2353 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J2353
Sources: CMS Medicare Coverage Database billing and coding articles (covered ICD-10 code lists and HCPCS links); ICD-10-CM FY2026; CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026 (non-rural state fees). Not billing or legal advice.