Is D38.1 a billable ICD-10-CM code?

Yes. D38.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does D38.1 sit in the tabular list?

Neoplasms (C00-D49), in the block Neoplasms of uncertain behavior, polycythemia vera and myelodysplastic syndromes (D37-D48).

D38.1

D38.1 — Neoplasm of uncertain behavior of trachea, bronchus and lung

Billable / specific codeICD-10-CM

D38.1 is a billable, specific ICD-10-CM code for neoplasm of uncertain behavior of trachea, bronchus and lung. It is valid for submission on a claim.

Risk adjustment

D38.1 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

D38.1 is named in 22 Medicare coverage policies — 22 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A52480Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) - Policy Article
A53101Billing and Coding: MolDX: bioTheranostics Cancer TYPE ID® Update
A54188Billing and Coding: MolDX: bioTheranostics Cancer TYPE ID®
A54386Billing and Coding: MolDX: bioTheranostics Cancer TYPE ID® Update

How D38.1 is indexed

Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to D38.1.

Adenoma›bronchial
Adenomatosis›pulmonary
Tumor›bronchial alveolar, intravascular
Tumor›intravascular bronchial alveolar

Related codes at this level

Codes that share D38. If D38.1 is not quite right, the correct code is usually one of these.

Questions about D38.1

Is D38.1 a billable ICD-10-CM code?: Yes. D38.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does D38.1 sit in the tabular list?: Neoplasms (C00-D49), in the block Neoplasms of uncertain behavior, polycythemia vera and myelodysplastic syndromes (D37-D48).