Wiki Right Adrenal Myelolipoma ICD 10

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The alphabetic index in ICD-10 directs you from 'myelolipoma' to 'lipoma', which classifies to D17. Since the adrenal glands are retroperitoneal, D17.79 is the most correct code, in my opinion.
 
The book led me to the D17.79 but the D35.01 actually says the adrenal gland. I wasn't sure which way to go with this one.
 
I'm not a pathologist, but per my understanding, this is not a neoplasm of the adrenal tissue, but rather a lipoma that happens to be located in the adrenal area, so I believe D35.01 would not be correct here. And from a coding standpoint, it's best to go where the book directs you unless you have documented guidance that supports doing otherwise.
 
Neoplasm coding is not just about the site but also the tumor morphology. The difference with a myelolipoma it is classified as connective tissue rather than direct anatomical site/organ. Specifically, adrenal myelolipoma Indexes to Lipoma and is further classified as Benign lipomatous neoplasm. But an adrenal adenoma indexes to just benign neoplasm by site. Both are benign neoplasms but have different morphology classifications and therefore different coding classifications. So this code, I follow the Index and Tabular; which leads to D17 category - D17.79 would be the most applicable.
 
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