What is ICD-10 code D3A.00?

D3A.00 is the ICD-10-CM diagnosis code for Benign carcinoid tumor of unspecified site. A slow-growing benign tumor that produces hormones, located in an unspecified part of the body. It belongs to the ICD-10-CM chapter for neoplasms (c00-d49). D3A.00 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. D3A.00 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. D3A.00 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. D3A.00 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

What is the V28 vs V24 difference for D3A.00?

CMS phased in the V28 risk adjustment model over payment years 2024 (33%), 2025 (67%), and 2026 (100%), replacing V24. V28 consolidates HCC categories, removes some lower-acuity conditions, and recalibrates RAF weights across the entire model. D3A.00 is a payment HCC under V28 (Bladder, Colorectal, and Other Cancers) but was not retained as a payment HCC under V24. Both models can still appear in legacy data and in payer-specific lookback periods.

What should coders know when reporting D3A.00?

Carcinoid tumors have specific sites; use this code only when the primary site cannot be determined Review pathology reports carefully to identify the specific anatomical location for more precise coding Because D3A.00 maps to a payment HCC, the documentation must also satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's risk adjustment score.

2026 ICD-10-CM D3A.00: Benign carcinoid tumor

ICD-10-CM Code View

HCC Buddy Code Card

Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.

Code lookupD3A.00Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Neoplasms (C00-D49) / Benign neuroendocrine tumors (D3A)

D3A.00

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Benign carcinoid tumor of unspecified site

A slow-growing benign tumor that produces hormones, located in an unspecified part of the body.

Buddy Insight

Benign carcinoid tumor of unspecified site represents a well-differentiated neuroendocrine tumor (NET) with benign behavior whose anatomical origin has not been determined.

CMS-HCC V28

Mapped

HCC 22

Bladder, Colorectal, and Othe...

RAF 0.363

CMS-HCC V24

N/A

—

Not risk-adjusted for this model/period.

Not mapped

ACA/HHS

N/A

—

Not risk-adjusted for this model/period.

Not mapped

ESRD/PACE

N/A

—

Not risk-adjusted for this model/period.

Not mapped

RXHCC

Mapped

HCC 22

Cancer, Other Specified Sites

RAF 0.124

Code Book Path

Official

D3ABenign neuroendocrine tumors

D3A.0Benign carcinoid tumors

D3A.00Benign carcinoid tumor of unspecified site

Inclusion Terms

Official

Carcinoid tumor NOS

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for D3A.00 in this effective period.

Related Child Codes

Official

D3A.01Benign carcinoid tumors of the small intestine

D3A.02Benign carcinoid tumors of the appendix, large intestine, and rectum

D3A.09Benign carcinoid tumors of other sites

Includes

Official

ICD-10-CM does not list Includes notes for D3A.00 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for D3A.00 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for D3A.00 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for D3A.00 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for D3A.00 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Pathology confirming a well-differentiated neuroendocrine tumor with low proliferative index (Ki-67 less than 3%) and benign behavior.

Every effort should be made to identify the primary site through imaging (CT, MRI, octreotide scan) and endoscopy.

Document serum chromogranin A levels, 24-hour urine 5-HIAA if carcinoid syndrome is suspected, and the reason the primary site is unknown.

MEAT Support

HCC Buddy guidance

Pathology confirming a well-differentiated neuroendocrine tumor with low proliferative index (Ki-67 less than 3%) and benign behavior.

Every effort should be made to identify the primary site through imaging (CT, MRI, octreotide scan) and endoscopy.

Document serum chromogranin A levels, 24-hour urine 5-HIAA if carcinoid syndrome is suspected, and the reason the primary site is unknown.

Audit Caution

HCC Buddy guidance

The distinction between benign (D3A) and malignant (C7A) carcinoid tumors depends on histologic grade, size, and invasion

review pathology carefully. Do not default to unspecified site when imaging has localized the primary tumor. Carcinoid syndrome should be coded separately with E34.0 in addition to the tumor code.

Common Mistakes

HCC Buddy guidance

D3A.010-D3A.029 are site-specific benign carcinoid codes that should be used when the location is known

C7A series codes are for malignant carcinoid tumors

E34.0 (carcinoid syndrome) should be coded additionally if the patient has flushing, diarrhea, or bronchospasm from tumor hormone secretion.

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Is D3A.00 an HCC code?

Yes. D3A.00 (Benign carcinoid tumor of unspecified site) maps to Bladder, Colorectal, and Other Cancers under the CMS-HCC V28 risk adjustment model, with a community non-dual aged RAF of 0.363. It is billable for payment year 2026.

Coder answer: D3A.00 is billable and maps to V28 HCC 22, Bladder, Colorectal, and Other Cancers. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code: D3A.00
Description: Benign carcinoid tumor of unspecified site
HCC (V28): HCC 22 — Bladder, Colorectal, and Other Cancers
RAF: 0.363
Billable: Yes
Payment year: 2026

HCC Category Mapping

V28HCC 22, Bladder, Colorectal, and Other Cancers

0.363

RxHCCHCC 22, Cancer, Other Specified Sites

0.124

Each model's RAF is its CMS base weight for that model's standard population, so weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.

Work D3A.00 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for D3A.00

For D3A.00 to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically, it has to be re-documented and supported each calendar year.

MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
EEvaluate: test results, medication response, or physical findings reviewed by the provider
AAssess: explicit mention in the assessment or plan with acknowledgment of status
TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis

Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed D3A.00 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

D3A.00 is the ICD-10-CM diagnosis code for benign carcinoid tumor of unspecified site. A slow-growing benign tumor that produces hormones, located in an unspecified part of the body. D3A.00 sits in the ICD-10-CM chapter for neoplasms (c00-d49), within the section covering benign neuroendocrine tumors (d3a).

Under the CMS-HCC V28 risk adjustment model, D3A.00 maps to Bladder, Colorectal, and Other Cancers (HCC 22) with a community, non-dual, aged base RAF weight of 0.363. D3A.00 was not retained as a payment HCC under the older V24 model, so V28 introduced or recategorized it during the 2024–2026 phase-in. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition.

Carcinoid tumors have specific sites; use this code only when the primary site cannot be determined. Because D3A.00 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for D3A.00 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Carcinoid tumors have specific sites; use this code only when the primary site cannot be determined
•Review pathology reports carefully to identify the specific anatomical location for more precise coding

Clinical Significance

Benign carcinoid tumor of unspecified site represents a well-differentiated neuroendocrine tumor (NET) with benign behavior whose anatomical origin has not been determined. Carcinoid tumors are slow-growing neoplasms that can produce serotonin and other vasoactive substances, potentially causing carcinoid syndrome. The unspecified site designation suggests incomplete workup or documentation and should prompt investigation to identify the primary site.

Documentation Requirements

✓Pathology confirming a well-differentiated neuroendocrine tumor with low proliferative index (Ki-67 less than 3%) and benign behavior.
✓Every effort should be made to identify the primary site through imaging (CT, MRI, octreotide scan) and endoscopy.
✓Document serum chromogranin A levels, 24-hour urine 5-HIAA if carcinoid syndrome is suspected, and the reason the primary site is unknown.

Commonly Confused Codes

•D3A.010-D3A.029 are site-specific benign carcinoid codes that should be used when the location is known
•C7A series codes are for malignant carcinoid tumors
•E34.0 (carcinoid syndrome) should be coded additionally if the patient has flushing, diarrhea, or bronchospasm from tumor hormone secretion.