D3A.022
BillableBenign carcinoid tumor of the ascending colon
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is D3A.022 an HCC code?
Yes. D3A.022 maps to Bladder, Colorectal, 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.022
For D3A.022to 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.022 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
D3A.022 is the ICD-10-CM diagnosis code for benign carcinoid tumor of the ascending colon. A benign neuroendocrine tumor located in the ascending colon, the first vertical section of the large intestine on the right side. D3A.022 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.022 maps to Bladder, Colorectal, and Other Cancers (HCC 22) with a community, non-dual, aged base RAF weight of 0.363. D3A.022 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.
Confirm the tumor location is specifically the ascending colon, not other colon segments. Because D3A.022 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.022 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Confirm the tumor location is specifically the ascending colon, not other colon segments
- •Document whether the tumor is causing any obstruction or other complications
Clinical Significance
Benign carcinoid tumor of the ascending colon is a rare well-differentiated neuroendocrine tumor arising in the ascending portion of the right colon. Colonic carcinoid tumors are uncommon compared to small bowel and appendiceal locations, and ascending colon carcinoids may present with vague abdominal symptoms, anemia, or be discovered incidentally during colonoscopy. They require careful pathologic assessment as colonic carcinoids have a higher malignant potential than appendiceal carcinoids.
Documentation Requirements
- ✓Colonoscopy or surgical pathology confirming a well-differentiated neuroendocrine tumor with documentation of the ascending colon location.
- ✓Include tumor size, Ki-67 proliferative index, mitotic rate, and depth of invasion.
- ✓Document the treatment approach (endoscopic resection vs.
- ✓right hemicolectomy) and planned surveillance colonoscopy interval.
- ✓Biochemical markers should be included if carcinoid syndrome is suspected.
Commonly Confused Codes
- •D3A.021 (cecum) is for the adjacent cecal location
- •D3A.025 (transverse colon) is for the next colonic segment
- •C7A.022 (malignant carcinoid of ascending colon) is for tumors demonstrating malignant behavior
- •D12.2 (benign neoplasm of ascending colon) covers other benign tumors like adenomatous polyps.