Question 1

What is ICD-10 code D11?

Accepted Answer

D11 is the ICD-10-CM diagnosis code for benign neoplasm of major salivary glands. D11 sits in the ICD-10-CM chapter for neoplasms (c00-d49), within the section covering benign neoplasms, except benign neuroendocrine tumors (d10-d36).

Header codes like D11 cannot be reported on claims directly; they organize child codes that share clinical context. Coders should select the billable child code that matches the documented presentation and then verify its current source-backed HCC mapping. Do not infer a child code or risk adjustment value from the header alone.

Question 2

Is D11 an HCC code?

Accepted Answer

D11 is a non-billable header code, so it cannot itself be a payment HCC. Header codes organize more specific child codes that share the same root concept; one of those children may map to a payment HCC under the CMS-HCC V28 or V24 risk adjustment model. Coders should select a child code from the D11 hierarchy that matches the documented presentation, then check that specific child for HCC status.

Question 3

Is D11 billable?

Accepted Answer

No. D11 is a header (non-billable) ICD-10-CM code. Header codes sit at a higher level of the diagnosis hierarchy and exist to organize a family of more specific child codes. Per ICD-10-CM coding guidelines, a header code cannot be reported on a claim as the diagnosis, coders must select a billable child code from the D11 hierarchy that matches the highest level of specificity supported by the provider's documentation. Payers reject header codes submitted as the primary diagnosis.

Question 4

Which HCC does D11 map to under V28?

Accepted Answer

D11 does not map to a CMS-HCC V28 payment category. Check the current CMS-HCC V28 model file for payment year 2026 rather than an older V24 tip sheet.

Question 5

What RAF reference is published for D11?

Accepted Answer

D11 has no separately stated V28 community reference coefficient. Check the current CMS mapping and factor files before using it in any member-score workflow.

Question 6

What documentation supports D11?

Accepted Answer

D11 is not a CMS-HCC payment code, so MEAT is not the payment hook. Documentation still has to support the diagnosis if you report it.

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D11

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What This Code Means

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Code Hierarchy

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D11 ICD-10-CM Code: Benign neoplasm of major salivary glands