D31.42
D31.42 — Benign neoplasm of left ciliary body
Billable / specific codeICD-10-CMleft
D31.42 is a billable, specific ICD-10-CM code for benign neoplasm of left ciliary body. It is valid for submission on a claim.
Risk adjustment
D31.42 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Medicare coverage
D31.42 is named in 20 Medicare coverage policies — 20 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A53060Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
- A56464Billing and Coding: Flow Cytometry
- A56537Billing and Coding: Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)
- A56551Billing and Coding: Visual Fields Testing
Related codes at this level
Codes that share D31.4. If D31.42 is not quite right, the correct code is usually one of these.
Questions about D31.42
- Is D31.42 a billable ICD-10-CM code?
- Yes. D31.42 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does D31.42 sit in the tabular list?
- Neoplasms (C00-D49), in the block Benign neoplasms, except benign neuroendocrine tumors (D10-D36).