D3A.026

D3A.026: Benign carcinoid tumor of the rectum

Billable / specific codeICD-10-CM

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.

Check D3A.026 with the rest of the claim: free scrubber

Excludes2 inherited from the categories above D3A.026

Not part of this code, but both may be coded when both are present.

Written on D3A: Benign neuroendocrine tumors

benign pancreatic islet cell tumors (D13.7)

Other codes that can never be billed with D3A.026

Their own Excludes1 notes name this code, so the conflict is not listed above.

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. Look up the whole chart to see which of its HCCs the hierarchy would zero.

Medicare coverage

D3A.026 is named in 10 Medicare coverage policies: 10 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

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

Alphabetic index entries that lead here

Tumor›carcinoid›benign›rectum

Code history

Unchanged in every release from FY2024 to FY2027.