D3A.026 — Benign carcinoid tumor of the rectum
D3A.026 is a billable, specific ICD-10-CM code for benign carcinoid tumor of the rectum. It is valid for submission on a claim.
Other codes that can never be billed with D3A.026
These codes carry an Excludes1 note pointing at D3A.026. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading D3A.026 alone.
- D12.8Benign neoplasm of rectum
Risk adjustment
D3A.026 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 22 Bladder, Colorectal, and Other Cancers0.363 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.
Medicare coverage
D3A.026 is named in 12 Medicare coverage policies — 12 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A52986Billing and Coding: Biomarkers for Oncology
- A56394Billing and Coding: Colonoscopy and Sigmoidoscopy-Diagnostic
- A56421Billing and Coding: CT of the Abdomen and Pelvis
- A56456Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
How D3A.026 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 D3A.026.
- Tumor›carcinoid›benign›rectum
Related codes at this level
Codes that share D3A.02. If D3A.026 is not quite right, the correct code is usually one of these.
- D3A.020Benign carcinoid tumor of the appendix
- D3A.021Benign carcinoid tumor of the cecum
- D3A.022Benign carcinoid tumor of the ascending colon
- D3A.023Benign carcinoid tumor of the transverse colon
- D3A.024Benign carcinoid tumor of the descending colon
- D3A.025Benign carcinoid tumor of the sigmoid colon
- D3A.029Benign carcinoid tumor of the large intestine, unspecified portion
Questions about D3A.026
- Is D3A.026 a billable ICD-10-CM code?
- Yes. D3A.026 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does D3A.026 sit in the tabular list?
- Neoplasms (C00-D49), in the block Benign neuroendocrine tumors (D3A).