What is ICD-10 code D3A.023?

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. It belongs to the ICD-10-CM chapter for neoplasms (c00-d49). D3A.023 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. D3A.023 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.023 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.023 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.

Which HCC does D3A.023 map to under V28?

D3A.023 maps to CMS-HCC V28 22 (Bladder, Colorectal, and Other Cancers). The category number and label come from the CMS-HCC V28 model file for payment year 2026.

What does D3A.023 pay in RAF?

D3A.023 carries a community, non-dual, aged (CNA) RAF weight of 0.363 under CMS-HCC V28 for payment year 2026. The weight comes from the CMS V28 relative-factor file, not a hand-typed table.

What is the V28 vs V24 difference for D3A.023?

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.023 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.

2026 ICD-10-CM D3A.023: Benign carcinoid tumor

D3A.023 maps to CMS-HCC V28 22 (RAF 0.363). Documentation must support MEAT. MEAT criteria · RAF calculator · HCC coding software

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Code lookupD3A.023Effective periodFY2026 Apr Update (Apr 1-Sep 30)

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

D3A.023

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

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.

Buddy Insight

Benign carcinoid tumors of the transverse colon are slow-growing neuroendocrine neoplasms that arise from enterochromaffin cells in the colonic mucosa.

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

D3A.0Benign carcinoid tumors

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

D3A.023Benign carcinoid tumor of the transverse colon

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for D3A.023 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for D3A.023 in this effective period.

Related Child Codes

Official

D3A.020Benign carcinoid tumor of the appendix

D3A.021Benign carcinoid tumor of the cecum

D3A.022Benign carcinoid tumor of the ascending colon

D3A.024Benign carcinoid tumor of the descending colon

D3A.025Benign carcinoid tumor of the sigmoid colon

Includes

Official

ICD-10-CM does not list Includes notes for D3A.023 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for D3A.023 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for D3A.023 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for D3A.023 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for D3A.023 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

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.

MEAT Support

HCC Buddy guidance

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.

Audit Caution

HCC Buddy guidance

Do not confuse benign carcinoid (D3A) codes with malignant carcinoid (C7A) codes, as they have fundamentally different prognostic and treatment implications.

Avoid using the unspecified large intestine code D3A.029 when the transverse colon is clearly documented.

Ensure the pathology explicitly states benign behavior before assigning this code.

Common Mistakes

HCC Buddy guidance

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.

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.023 an HCC code?

Yes. D3A.023 (Benign carcinoid tumor of the transverse colon) 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.023 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.023
Description: Benign carcinoid tumor of the transverse colon
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.023 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for D3A.023

For D3A.023 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.023 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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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.