D11.9
BillableBenign neoplasm of major salivary gland, unspecified
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is D11.9 an HCC code?
No. D11.9 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
D11.9 is the ICD-10-CM diagnosis code for benign neoplasm of major salivary gland, unspecified. A benign (non-cancerous) tumor that has developed in one of the major salivary glands, but the specific gland location has not been documented. Major salivary glands include the parotid, submandibular, and sublingual glands located in and around the mouth and jaw area. D11.9 sits in the ICD-10-CM chapter for neoplasms (c00-d49), within the section covering benign neoplasms, except benign neuroendocrine tumors (d10-d36).
D11.9 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.
Query the provider to identify which specific salivary gland is affected (parotid, submandibular, or sublingual) to assign a more specific code (D11.0, D11.7, or D11.8) rather than using the unspecified code D11.9.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for D11.9 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Query the provider to identify which specific salivary gland is affected (parotid, submandibular, or sublingual) to assign a more specific code (D11.0, D11.7, or D11.8) rather than using the unspecified code D11.9
- •Ensure documentation distinguishes between benign neoplasm (D11.9) and malignant neoplasm of salivary glands (C07-C08 codes) to avoid miscoding