D42.0
D42.0 — Neoplasm of uncertain behavior of cerebral meninges
Billable / specific codeICD-10-CM
D42.0 is a billable, specific ICD-10-CM code for neoplasm of uncertain behavior of cerebral meninges. It is valid for submission on a claim.
Risk adjustment
D42.0 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 23 Prostate, Breast, and Other Cancers and Tumors0.186 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
D42.0 is named in 34 Medicare coverage policies — 34 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
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- A55315Billing and Coding: Proton Beam Therapy
- A56462Billing and Coding: Erythropoiesis Stimulating Agents (ESA)
Related codes at this level
Codes that share D42. If D42.0 is not quite right, the correct code is usually one of these.
Questions about D42.0
- Is D42.0 a billable ICD-10-CM code?
- Yes. D42.0 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does D42.0 sit in the tabular list?
- Neoplasms (C00-D49), in the block Neoplasms of uncertain behavior, polycythemia vera and myelodysplastic syndromes (D37-D48).