D3A.011
BillableBenign carcinoid tumor of the jejunum
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is D3A.011 an HCC code?
Yes. D3A.011 maps to Colorectal, Bladder, and Other Cancers under the CMS-HCC V28 risk adjustment model.
HCC Category Mapping
RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. 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.
MEAT Criteria for D3A.011
For D3A.011to 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.011 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
D3A.011 is the ICD-10-CM diagnosis code for benign carcinoid tumor of the jejunum. A slow-growing benign hormone-producing tumor found in the jejunum (middle section of the small intestine). D3A.011 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.011 maps to Colorectal, Bladder, and Other Cancers (HCC 22) with a community, non-dual, aged base RAF weight of 0.000. D3A.011 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.
Jejunal carcinoid tumors may be associated with carcinoid syndrome; document any systemic symptoms. Because D3A.011 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.011 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Jejunal carcinoid tumors may be associated with carcinoid syndrome; document any systemic symptoms
- •Verify the exact location (jejunum vs. duodenum vs. ileum) from endoscopy or surgical reports
Clinical Significance
Benign carcinoid tumor of the jejunum is a well-differentiated neuroendocrine tumor of the mid-small intestine. Small intestinal carcinoids are the most common small bowel neoplasms, and jejunal tumors may present with vague abdominal symptoms or be discovered incidentally during imaging or surgery. These tumors have a higher propensity for carcinoid syndrome than duodenal carcinoids due to their midgut origin and serotonin production.
Documentation Requirements
- ✓Pathologic confirmation from surgical resection or biopsy demonstrating a well-differentiated neuroendocrine tumor with low-grade features.
- ✓Confirm jejunal location from surgical or imaging reports.
- ✓Document Ki-67 proliferative index, tumor size, and depth of invasion.
- ✓Include 24-hour urine 5-HIAA and serum chromogranin A results.
- ✓Note any symptoms of carcinoid syndrome.
Commonly Confused Codes
- •D3A.010 (duodenum) and D3A.012 (ileum) are for adjacent small intestine segments
- •D3A.019 (small intestine, unspecified) should be avoided when jejunal location is documented
- •C7A.011 (malignant carcinoid of jejunum) is for tumors demonstrating malignant behavior.