D37.09
BillableNeoplasm of uncertain behavior of other specified sites of the oral cavity
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is D37.09 an HCC code?
No. D37.09 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
D37.09 is the ICD-10-CM diagnosis code for neoplasm of uncertain behavior of other specified sites of the oral cavity. A growth in the mouth or oral cavity (other than the specific salivary glands or lip) with uncertain behavior that requires further evaluation. D37.09 sits in the ICD-10-CM chapter for neoplasms (c00-d49), within the section covering neoplasms of uncertain behavior, polycythemia vera and myelodysplastic syndromes (d37-d48).
D37.09 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.
Use this code for oral cavity sites not specified elsewhere, such as tongue, gums, or hard palate with uncertain behavior.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for D37.09 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.