Is D43.9 a billable ICD-10-CM code?

Yes. D43.9 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does D43.9 sit in the tabular list?

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

D43.9

D43.9 — Neoplasm of uncertain behavior of central nervous system, unspecified

Billable / specific codeICD-10-CM

D43.9 is a billable, specific ICD-10-CM code for neoplasm of uncertain behavior of central nervous system, unspecified. It is valid for submission on a claim.

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Neoplasm of uncertain behavior of nervous system (central) NOS

Risk adjustment

D43.9 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

D43.9 is named in 9 Medicare coverage policies — 9 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
A56612Billing and Coding: CT of the Head
A56695Billing and Coding: Implantable Infusion Pump
A56722Billing and Coding: Intraoperative Neurophysiological Testing

Related codes at this level

Codes that share D43. If D43.9 is not quite right, the correct code is usually one of these.

Questions about D43.9

Is D43.9 a billable ICD-10-CM code?: Yes. D43.9 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does D43.9 sit in the tabular list?: Neoplasms (C00-D49), in the block Neoplasms of uncertain behavior, polycythemia vera and myelodysplastic syndromes (D37-D48).