D41.3
BillableNeoplasm of uncertain behavior of urethra
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is D41.3 an HCC code?
No. D41.3 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
D41.3 is the ICD-10-CM diagnosis code for neoplasm of uncertain behavior of urethra. This code describes an abnormal growth in the urethra (the tube that carries urine out of the body) that cannot yet be determined to be cancer or benign. The growth requires further testing or monitoring to determine its true nature. D41.3 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).
D41.3 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.
Ensure documentation specifies the urethra as the site and that the behavior is truly uncertain rather than confirmed benign or malignant.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for D41.3 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Ensure documentation specifies the urethra as the site and that the behavior is truly uncertain rather than confirmed benign or malignant
- •Do not use this code if the neoplasm has been definitively classified as malignant (C-codes) or benign (D-codes with different behavior classification)