Is D42.1 a billable ICD-10-CM code?

Yes. D42.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does D42.1 sit in the tabular list?

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

D42.1

D42.1 — Neoplasm of uncertain behavior of spinal meninges

Billable / specific codeICD-10-CM

D42.1 is a billable, specific ICD-10-CM code for neoplasm of uncertain behavior of spinal meninges. It is valid for submission on a claim.

Risk adjustment

D42.1 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

D42.1 is named in 35 Medicare coverage policies — 35 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A52370Billing and Coding: Bevacizumab and biosimilars
A52480Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) - Policy Article
A55315Billing and Coding: Proton Beam Therapy
A56396Billing and Coding: Lumbar Spinal Fusion

Related codes at this level

Codes that share D42. If D42.1 is not quite right, the correct code is usually one of these.

Questions about D42.1

Is D42.1 a billable ICD-10-CM code?: Yes. D42.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does D42.1 sit in the tabular list?: Neoplasms (C00-D49), in the block Neoplasms of uncertain behavior, polycythemia vera and myelodysplastic syndromes (D37-D48).