D43
D43 — Neoplasm of uncertain behavior of brain and central nervous system
Non-billable headerICD-10-CM
D43 is a non-billable header ICD-10-CM code for neoplasm of uncertain behavior of brain and central nervous system. It cannot be billed on its own: choose one of the more specific child codes below.
Excludes1 — never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
- neoplasm of uncertain behavior of peripheral nerves and autonomic nervous system (D48.2)
Other codes that can never be billed with D43
These codes carry an Excludes1 note pointing at D43. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading D43 alone.
- D43.0Neoplasm of uncertain behavior of brain, supratentorial
Risk adjustment
D43 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.
Code to one of these instead D43
7 child codes. Green means billable.
- D43.0Neoplasm of uncertain behavior of brain, supratentorial
- D43.1Neoplasm of uncertain behavior of brain, infratentorial
- D43.2Neoplasm of uncertain behavior of brain, unspecified
- D43.3Neoplasm of uncertain behavior of cranial nerves
- D43.4Neoplasm of uncertain behavior of spinal cord
- D43.8Neoplasm of uncertain behavior of other specified parts of central nervous system
- D43.9Neoplasm of uncertain behavior of central nervous system, unspecified
Questions about D43
- Is D43 a billable ICD-10-CM code?
- No. D43 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does D43 sit in the tabular list?
- Neoplasms (C00-D49), in the block Neoplasms of uncertain behavior, polycythemia vera and myelodysplastic syndromes (D37-D48).
- What cannot be coded together with D43?
- D43 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.