D3A.090
BillableBenign carcinoid tumor of the bronchus and lung
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is D3A.090 an HCC code?
Yes. D3A.090 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.090
For D3A.090to 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.090 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
D3A.090 is the ICD-10-CM diagnosis code for benign carcinoid tumor of the bronchus and lung. A slow-growing, benign tumor of the lung or bronchus that produces hormones; these tumors are typically found incidentally and rarely cause symptoms. D3A.090 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.090 maps to Bladder, Colorectal, and Other Cancers (HCC 22) with a community, non-dual, aged base RAF weight of 0.363. D3A.090 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.
Verify the exact anatomical site (bronchus vs. lung) from the pathology report before coding. Because D3A.090 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.090 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify the exact anatomical site (bronchus vs. lung) from the pathology report before coding
- •Distinguish from malignant carcinoid tumors (C7A codes) - benign carcinoid tumors have better prognosis and different treatment approaches
Clinical Significance
Benign carcinoid tumors of the bronchus and lung account for approximately 25% of all carcinoid tumors and are the most common benign lung neoplasms. These slow-growing tumors are typically discovered incidentally on chest imaging and rarely cause carcinoid syndrome unless hepatic metastases develop, which would reclassify the tumor as malignant.
Documentation Requirements
- ✓Documentation must specify the bronchial or pulmonary location, confirmed by bronchoscopy, computed tomography, or surgical pathology.
- ✓The pathology report should confirm typical carcinoid histology with low mitotic rate and absence of necrosis.
- ✓Distinguish from atypical carcinoid, which has a higher malignant potential and different coding.