D3A.8
BillableOther benign neuroendocrine tumors
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is D3A.8 an HCC code?
Yes. D3A.8 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.8
For D3A.8to 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.8 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
D3A.8 is the ICD-10-CM diagnosis code for other benign neuroendocrine tumors. A benign tumor arising from neuroendocrine cells in various body locations that does not fit into the standard carcinoid tumor categories. D3A.8 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.8 maps to Bladder, Colorectal, and Other Cancers (HCC 22) with a community, non-dual, aged base RAF weight of 0.363. D3A.8 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.
This is a catch-all code for benign neuroendocrine tumors not classified elsewhere; use only when more specific codes do not apply. Because D3A.8 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.8 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This is a catch-all code for benign neuroendocrine tumors not classified elsewhere; use only when more specific codes do not apply
- •Ensure pathology confirms neuroendocrine differentiation and benign behavior before assigning this code
Clinical Significance
This code covers benign neuroendocrine tumors that are not classified as carcinoid tumors, such as paragangliomas, pheochromocytomas with benign behavior, or other non-carcinoid neuroendocrine neoplasms. These tumors arise from specialized neuroendocrine cells and may produce various hormones depending on their cell of origin.
Documentation Requirements
- ✓Documentation should identify the specific type of neuroendocrine tumor and confirm benign behavior on pathology.
- ✓Immunohistochemistry confirming neuroendocrine lineage is essential.
- ✓Any hormonal activity, associated syndromes (such as Multiple Endocrine Neoplasia), and tumor location should be documented.
Commonly Confused Codes
- •D3A.090-D3A.098 codes are used for benign carcinoid tumors specifically and should be used when the neuroendocrine tumor is classified as a carcinoid type.
- •C7A.8 (other malignant neuroendocrine tumors) is the malignant counterpart.
- •E27.5 (adrenomedullary hyperfunction) may be relevant for functional tumors.