D3A.029
BillableBenign carcinoid tumor of the large intestine, unspecified portion
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is D3A.029 an HCC code?
Yes. D3A.029 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.029
For D3A.029to 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.029 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
D3A.029 is the ICD-10-CM diagnosis code for benign carcinoid tumor of the large intestine, unspecified portion. A benign neuroendocrine tumor of the large intestine when the specific portion (cecum, colon, or rectum) is not identified. D3A.029 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.029 maps to Bladder, Colorectal, and Other Cancers (HCC 22) with a community, non-dual, aged base RAF weight of 0.363. D3A.029 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.
Use this code only when the exact location within the large intestine cannot be determined from documentation. Because D3A.029 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.029 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use this code only when the exact location within the large intestine cannot be determined from documentation
- •Query the provider to obtain more specific anatomical location when possible
Clinical Significance
This unspecified code represents a benign carcinoid tumor of the large intestine when the exact anatomical segment cannot be determined. While the clinical course is generally indolent, failure to specify the site limits prognostic assessment and treatment planning, as different colonic segments carry different risk profiles.
Documentation Requirements
- ✓This code should only be used when documentation does not specify the exact portion of the large intestine (cecum, ascending, transverse, descending, sigmoid colon, or rectum).
- ✓A provider query should be initiated to obtain the specific anatomical location from endoscopy, radiology, or surgical reports whenever possible.
Commonly Confused Codes
- •D3A.020 through D3A.026 are site-specific codes that should be used when the exact location is documented.
- •C7A.029 (malignant carcinoid of large intestine, unspecified) is the malignant counterpart.
- •D37.4 (neoplasm of uncertain behavior of colon) is used when the behavior itself is uncertain.