D41.3 ICD-10-CM Code: Neoplasm of uncertain behavior of urethra
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FY 2026 Apr update / Neoplasms (C00-D49) / Neoplasms of uncertain behavior, polycythemia vera and myelodysplastic syndromes (D37-D48)
D41.3
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceNeoplasm 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.
CMS-HCC V28
00
RAF 0
CMS-HCC V24
00
RAF 0
ACA/HHS
00
RAF 0
ESRD/PACE
00
RAF 0
RXHCC
00
RAF 0
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Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for D41.3 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for D41.3 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for D41.3 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for D41.3 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for D41.3 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for D41.3 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for D41.3 in this effective period.
Buddy Documentation Tip
Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.
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.
Coder workflow notes
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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)