D40.0
D40.0 — Neoplasm of uncertain behavior of prostate
Billable / specific codeICD-10-CM
D40.0 is a billable, specific ICD-10-CM code for neoplasm of uncertain behavior of prostate. It is valid for submission on a claim.
Risk adjustment
D40.0 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
D40.0 is named in 29 Medicare coverage policies — 29 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
- A52986Billing and Coding: Biomarkers for Oncology
- A55717Billing and Coding: Lab: Flow Cytometry
- A56421Billing and Coding: CT of the Abdomen and Pelvis
Code history
D40.0 has not changed since FY2024 — no addition, revision or deletion across the FY2024–FY2027 ICD-10-CM releases.
Related codes at this level
Codes that share D40. If D40.0 is not quite right, the correct code is usually one of these.
Questions about D40.0
- Is D40.0 a billable ICD-10-CM code?
- Yes. D40.0 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does D40.0 sit in the tabular list?
- Neoplasms (C00-D49), in the block Neoplasms of uncertain behavior, polycythemia vera and myelodysplastic syndromes (D37-D48).