Question 1

What is ICD-10 code D48.110?

Accepted Answer

D48.110 is the ICD-10-CM diagnosis code for desmoid tumor of head and neck. A desmoid tumor is a rare, aggressive fibrous growth that develops in the head and neck region and can grow into surrounding tissues. D48.110 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).

D48.110 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.

Desmoid tumors are fibromatosis tumors with uncertain malignant potential; ensure pathology confirms this diagnosis.

Question 2

Is D48.110 an HCC code?

Accepted Answer

No. D48.110 is a billable ICD-10-CM code but does not map to any payment HCC category under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can still be reported on Medicare Advantage encounter data submissions, but it does not contribute to the beneficiary's Risk Adjustment Factor (RAF) score and therefore does not affect the risk-adjusted capitation payment to the plan. V28 reached 100% phase-in for payment year 2026.

Question 3

Is D48.110 billable?

Accepted Answer

Yes. D48.110 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. D48.110 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

Question 4

Which HCC does D48.110 map to under V28?

Accepted Answer

D48.110 does not map to a CMS-HCC V28 payment category. Check the current CMS-HCC V28 model file for payment year 2026 rather than an older V24 tip sheet.

Question 5

What does D48.110 pay in RAF?

Accepted Answer

D48.110 has no separately stated V28 community RAF weight. If it is not a V28 payment HCC, it adds nothing to a community RAF score.

Question 6

What is the V28 vs V24 difference for D48.110?

Accepted Answer

D48.110 does not map to a payment HCC under either the CMS-HCC V28 risk adjustment model or the older V24 model. V28 reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition. Because neither community model rewards D48.110 with a risk adjustment factor, it contributes zero to a Medicare Advantage beneficiary's V28/V24 community RAF score in either version. Coders should check whether provider documentation supports a more specific child code that does map to a community payment HCC.

Question 7

What documentation supports D48.110?

Accepted Answer

Desmoid tumors are fibromatosis tumors with uncertain malignant potential; ensure pathology confirms this diagnosis Specify the exact anatomical location within the head and neck region in documentation D48.110 is not a CMS-HCC payment code, so MEAT is not the payment hook. Documentation still has to support the diagnosis if you report it.

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D48.110

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D48.110 ICD-10-CM Code: Desmoid tumor of head and neck

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D48.110

Is D48.110 an HCC code?

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What This Code Means

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Child Codes

Code Hierarchy

D48.110 code history

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