D41.4
BillableNeoplasm of uncertain behavior of bladder
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is D41.4 an HCC code?
No. D41.4 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
D41.4 is the ICD-10-CM diagnosis code for neoplasm of uncertain behavior of bladder. This code describes an abnormal growth in the bladder that cannot yet be determined to be either cancer or benign (non-cancerous). It's used when a bladder tumor has been found but additional testing is needed to determine its true nature. D41.4 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).
D41.4 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.
Use this code only when pathology or clinical documentation explicitly states 'uncertain behavior' or 'unspecified malignant potential' - do not use for confirmed malignant or benign tumors.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for D41.4 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use this code only when pathology or clinical documentation explicitly states 'uncertain behavior' or 'unspecified malignant potential' - do not use for confirmed malignant or benign tumors
- •Ensure the site is specifically the bladder; if the neoplasm involves other urinary structures, verify the correct anatomical code (D41.0-D41.3 for other urinary sites)