ICD-10 Code D25.9: Uterine Fibroid (Leiomyoma) Billing Guide

What is ICD-10 code D25.9?

D25.9 is the ICD-10-CM code for leiomyoma of uterus, unspecified, the diagnosis for a uterine fibroid when the record does not state its type or location. It sits in Chapter 2, the neoplasms chapter, under category D25. For fiscal year 2026, effective October 1, 2025, D25.9 is a valid, billable code used in the non-pregnant context, since a fibroid in pregnancy is reported from the O34.1 family instead.

D25.9 vs the specific codes. Use D25.0 for submucous, D25.1 for intramural, and D25.2 for subserosal fibroids when the location is documented, and reserve D25.9 for when it is not.

Billable, but scrutinized. D25.9 is accepted on a claim, but as an unspecified code it can weaken medical necessity for fibroid procedures and raise audit risk.

Pair it with symptom codes. Codes such as N92.0 for heavy menstrual bleeding or N94.6 for dysmenorrhea build the medical-necessity story a payer needs to see.

What Is ICD-10 Code D25.9?

D25.9 stands for leiomyoma of uterus, unspecified. Leiomyoma is the clinical term for a uterine fibroid, a benign smooth-muscle growth in the uterus and the most common non-cancerous tumor in women of childbearing age. The final character, 9, signals that the record confirms a fibroid but does not state its type or location. The code lives in Chapter 2 of ICD-10-CM, the neoplasms chapter, under category D25.

The structure behind the code matters at the claim level. D25 on its own is a three-character category header and cannot be billed, because ICD-10-CM requires coding to the highest level of specificity available. D25.9 is the complete, billable form used when no further detail is documented. One practical billing note: when you submit electronically, enter the code without the decimal point, as D259, since some clearinghouses reject the decimal. If a patient is pregnant, a fibroid is reported from the O34.1 family for the pregnancy episode, coded to the trimester as O34.11, O34.12, or O34.13, rather than with D25.

One question we hear constantly from practice managers is whether D25.9 is simply the safe default when a chart is thin. It is not. Across the billing companies we vet, the OB/GYN specialists that keep denials low treat an unspecified code as a prompt to query the provider, not as a shortcut to close the claim.

The D25 Family of Fibroid Codes

Fibroids are coded by where they sit in the uterus, and that location is not just clinical detail. It is what payers use to judge whether a treatment is reasonable and necessary. Three of the four codes describe a specific location, and D25.9 is the fallback for everything else.

Code	Description	When to use it
D25.0	Submucous leiomyoma of uterus	Fibroid documented just beneath the uterine lining; often tied to heavy bleeding and fertility issues
D25.1	Intramural leiomyoma of uterus	Fibroid documented within the muscular wall of the uterus
D25.2	Subserosal leiomyoma of uterus	Fibroid documented on the outer surface of the uterus
D25.9	Leiomyoma of uterus, unspecified	Fibroid confirmed but the type or location is not documented anywhere in the record

The clinical reality is that an OB/GYN almost always knows the location after an ultrasound, MRI, or surgery, which is exactly why D25.9 should be the exception rather than the default. Under the FY2026 ICD-10-CM code set, D25.0, D25.1, D25.2, and D25.9 are all billable; only the bare D25 category is not.

Is D25.9 billable?

Yes. D25.9 is valid for HIPAA transactions and will be accepted on a claim, so on a technical level it is billable. The more useful question is whether it is the right code, and that is where fibroid claims get into trouble with payers.

Payers and auditors increasingly scrutinize unspecified diagnoses because they suggest the documentation was not detailed enough to support a more precise code. In gynecologic billing, an unspecified fibroid code submitted to justify an expensive procedure is a common trigger for a medical-necessity denial or a request for records, sometimes checked against a payer’s local coverage determination. A specific location code, such as D25.0 for a submucous fibroid tied to heavy bleeding, carries far more clinical weight when a procedure needs prior authorization. And if the operative note or ultrasound names the fibroid type while the claim still goes out as D25.9, the diagnosis does not match the record, which is a documentation and compliance gap.

The most common issue we see providers run into is a fibroid claim that reads unspecified when the operative note clearly named the location. The code was defensible on the day it went out; it stops being defensible the moment an auditor reads the chart beside it.

What is the difference between D25.9 and D25.0?

Both describe a uterine fibroid, but D25.0, submucous leiomyoma of uterus, is specific to a fibroid located just beneath the uterine lining, while D25.9 is the unspecified code used only when no location is documented. Submucous fibroids are strongly associated with heavy bleeding and fertility problems, so D25.0 helps justify hysteroscopic and other targeted procedures.

D25.0 is the most common point of confusion with D25.9, because submucous fibroids are the ones most often treated surgically and therefore the ones most often miscoded as unspecified under time pressure. The same logic separates D25.9 from D25.1 for intramural and D25.2 for subserosal fibroids. If an ultrasound, MRI, or operative note pins down the location, the specific code is the correct and defensible choice. Reserve D25.9 for the genuinely undocumented cases, and circle back to the provider to capture the detail whenever you can.

Pairing D25.9 With Symptom Codes

A fibroid diagnosis rarely travels alone. Most fibroid encounters are driven by symptoms, and coding those symptoms alongside the fibroid is what builds the clinical story a payer needs to see. Common companions include N92.0 for excessive and frequent menstruation with a regular cycle, the classic heavy menstrual bleeding picture, N94.6 for dysmenorrhea, unspecified, for the painful periods fibroids can cause, and other bleeding codes from the N92 and N93 families matched to what the chart documents.

Sequencing matters. When the visit or procedure is about the fibroid, the fibroid code generally leads as the reason for the encounter, with the symptom codes supporting it. When a patient presents primarily with a symptom and the fibroid is found during workup, the order can flip. Code what the record supports, in the order that reflects why the patient was seen.

D25.9 and Medical Necessity for Procedures

The diagnosis code is the foundation for getting fibroid treatment authorized and paid. Procedures such as myomectomy, endometrial ablation, uterine artery embolization, and laparoscopic hysterectomy (CPT 58571) all require a diagnosis that explains why the treatment is warranted. The more precisely the fibroid and its symptoms are coded, the stronger the medical-necessity case.

This is the practical cost of defaulting to D25.9. An unspecified fibroid code, with no supporting symptom codes, gives a payer little to work with when reviewing an expensive surgical request. A specific location code plus documented bleeding or pain tells a complete story and reduces the odds of a denial or a records request. Strong diagnosis coding upstream prevents authorization headaches downstream, which is the same discipline that separates a fibroid claim from a related diagnosis workup such as endometriosis.

Documentation and Audit-Risk Checklist

Before a fibroid claim leaves the practice, the record should make the following clear to any reviewer:

• Document the fibroid location or type when known, so the most specific D25 code can be selected over D25.9.
• Code the symptoms driving the encounter with the matching N92 or N94 codes where the chart supports them.
• Align the diagnosis on the claim with the findings in the ultrasound, MRI, or operative report.
• Build a clear medical-necessity narrative whenever a fibroid procedure is being authorized or billed.
• Confirm pregnancy status, since a fibroid in pregnancy is reported from the O34.1 family rather than D25.
• Query the provider before defaulting to D25.9, so unspecified coding stays the rare exception it should be.

Why Fibroid Coding Slips Through

Fibroid coding sits at the meeting point of clinical documentation, payer policy, and surgical authorization, and small habits in any one of those areas quietly cost a practice money. Defaulting to D25.9, skipping the symptom codes, or letting the claim drift out of sync with the operative note are easy mistakes to make and hard to catch without a coder paying attention to gynecologic specifics.

Providers often come to us after a payer starts denying fibroid procedures for medical necessity, which is usually a documentation and coding problem rather than a coverage one. That is the value of an OB/GYN-experienced billing partner. The hard part for most practices is not believing good billing companies exist, it is finding one that actually understands fibroid coding, medical necessity, and prior authorization without a long and costly trial period. OB/GYN Bill Co reviews every request by hand and matches your practice with billing companies that code gynecologic claims like this one every day. If your denials are clustering around diagnosis specificity, the same review applies to related workups such as endometriosis coding (N80.9).

Frequently Asked Questions

Next Steps

Coding a fibroid hysterectomy? See our guide to laparoscopic hysterectomy billing (CPT 58571).

Working a related diagnosis? Review endometriosis coding (N80.9).

Denials clustering around specificity? Get matched with an OB/GYN billing company that codes gynecologic claims every day.