D3A.092 ICD-10-CM Code: Benign carcinoid tumor of the stomach
D3A.092 maps to CMS-HCC V28 22. A source-labeled RAF reference is available. Documentation must support MEAT. MEAT criteria · RAF Calculator · HCC coding software
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FY 2026 Apr update / Neoplasms (C00-D49) / Benign neuroendocrine tumors (D3A)
D3A.092
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceBenign carcinoid tumor of the stomach
A benign, slow-growing hormone-producing tumor of the stomach that may cause abdominal symptoms or be found during endoscopy.
Buddy Insight
Benign carcinoid tumors of the stomach (gastric carcinoids) represent a spectrum of neuroendocrine neoplasms that are increasingly identified during upper endoscopy.
CMS-HCC V28
MappedHCC 22
Code-level coefficient reference
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
MappedHCC 22
Code-level coefficient reference
Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for D3A.092 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for D3A.092 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for D3A.092 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for D3A.092 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for D3A.092 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for D3A.092 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for D3A.092 in this effective period.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
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.092 an HCC code?
Yes. D3A.092 (Benign carcinoid tumor of the stomach) maps to HCC 22, Bladder, Colorectal, and Other Cancers under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 0.363. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes. It is billable for payment year 2026.
Coder answer: D3A.092 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.092
- Description
- Benign carcinoid tumor of the stomach
- HCC (V28)
- HCC 22 — Bladder, Colorectal, and Other Cancers
- RAF reference coefficient
- 0.363
- Billable
- Yes
- Payment year
- 2026
HCC Category Mapping
These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. 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 context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.
Work D3A.092 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →
MEAT Criteria for D3A.092
For D3A.092 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.092 during that encounter, not just copy-forwarded from a problem list.
Coder workflow notes
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What This Code Means
D3A.092 is the ICD-10-CM diagnosis code for benign carcinoid tumor of the stomach. A benign, slow-growing hormone-producing tumor of the stomach that may cause abdominal symptoms or be found during endoscopy. D3A.092 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.092 maps to Bladder, Colorectal, and Other Cancers (HCC 22) with a source-labeled community, non-dual, aged reference coefficient of 0.363. No V24 mapping is shown for D3A.092; use the applicable model and payment year when reviewing the V28 mapping. 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. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes.
Document the specific location within the stomach (fundus, body, antrum) if available for more precise coding. Because D3A.092 maps to an HCC category, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) before the diagnosis is used for risk adjustment. 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, source-labeled coefficient references, and MEAT documentation criteria for D3A.092 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Document the specific location within the stomach (fundus, body, antrum) if available for more precise coding
- •Verify the tumor is benign and not a gastric neuroendocrine carcinoma (C16.9) based on pathology findings
Clinical Significance
Benign carcinoid tumors of the stomach (gastric carcinoids) represent a spectrum of neuroendocrine neoplasms that are increasingly identified during upper endoscopy. Type I gastric carcinoids (associated with chronic atrophic gastritis) are the most common and have an excellent prognosis, while types II and III carry different risk profiles that may affect behavior classification.
Documentation Requirements
- ✓Documentation must specify the gastric location and the type of gastric carcinoid (Type I, II, or III) when available, as each has different clinical implications.
- ✓Pathology should confirm benign behavior, neuroendocrine markers, tumor size, and gastrin levels if relevant.
- ✓Endoscopic ultrasound findings regarding depth of invasion should be included.