D43.3
D43.3 — Neoplasm of uncertain behavior of cranial nerves
Billable / specific codeICD-10-CM
D43.3 is a billable, specific ICD-10-CM code for neoplasm of uncertain behavior of cranial nerves. It is valid for submission on a claim.
Risk adjustment
D43.3 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
D43.3 is named in 24 Medicare coverage policies — 24 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
- A56462Billing and Coding: Erythropoiesis Stimulating Agents (ESA)
- A56580Billing and Coding: Computerized Axial Tomography (CT), Thorax
- A56612Billing and Coding: CT of the Head
Related codes at this level
Codes that share D43. If D43.3 is not quite right, the correct code is usually one of these.
- D43.0Neoplasm of uncertain behavior of brain, supratentorial
- D43.1Neoplasm of uncertain behavior of brain, infratentorial
- D43.2Neoplasm of uncertain behavior of brain, unspecified
- D43.4Neoplasm 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 D43.3
- Is D43.3 a billable ICD-10-CM code?
- Yes. D43.3 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does D43.3 sit in the tabular list?
- Neoplasms (C00-D49), in the block Neoplasms of uncertain behavior, polycythemia vera and myelodysplastic syndromes (D37-D48).