D41.20
BillableNeoplasm of uncertain behavior of unspecified ureter
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is D41.20 an HCC code?
No. D41.20 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
D41.20 is the ICD-10-CM diagnosis code for neoplasm of uncertain behavior of unspecified ureter. A growth in the ureter (the tube that carries urine from the kidney to the bladder) of unspecified side with uncertain malignant potential. D41.20 sits in the ICD-10-CM chapter for neoplasms (c00-d49), within the section covering neoplasms of uncertain behavior, polycythemia vera and myelodysplastic syndromes (d37-d48).
D41.20 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.
Distinguish between ureter (D41.2) and renal pelvis (D41.1) based on anatomical location in documentation.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for D41.20 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.