D3A.023
BillableBenign carcinoid tumor of the transverse colon
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is D3A.023 an HCC code?
Yes. D3A.023 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.023
For D3A.023to 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.023 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
D3A.023 is the ICD-10-CM diagnosis code for benign carcinoid tumor of the transverse colon. A benign neuroendocrine tumor found in the transverse colon, the horizontal section of the large intestine that crosses the abdomen. D3A.023 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.023 maps to Bladder, Colorectal, and Other Cancers (HCC 22) with a community, non-dual, aged base RAF weight of 0.363. D3A.023 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.
Ensure documentation clearly identifies the transverse colon as the site. Because D3A.023 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.023 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Ensure documentation clearly identifies the transverse colon as the site
- •Note any associated symptoms or complications in the medical record
Clinical Significance
Benign carcinoid tumors of the transverse colon are slow-growing neuroendocrine neoplasms that arise from enterochromaffin cells in the colonic mucosa. While classified as benign, these tumors require surveillance due to their potential for hormonal secretion and rare progression, and they carry implications for long-term gastrointestinal monitoring.
Documentation Requirements
- ✓Documentation must specify the exact anatomical location as the transverse colon, confirmed by colonoscopy or surgical pathology.
- ✓The pathology report should confirm benign behavior, tumor size, depth of invasion, and Ki-67 proliferation index.
- ✓Note any associated carcinoid syndrome symptoms such as flushing, diarrhea, or wheezing.
Commonly Confused Codes
- •C7A.023 (malignant carcinoid tumor of the transverse colon) is used when pathology confirms malignant behavior.
- •D37.4 (neoplasm of uncertain behavior of colon) is used when the behavior cannot be determined.
- •D3A.029 (benign carcinoid of large intestine, unspecified) should not be used when the transverse colon is specifically documented.