D48.4 ICD-10-CM Code: Neoplasm of uncertain behavior of peritoneum
D48.4 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC coding software
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FY 2026 Apr update / Neoplasms (C00-D49) / Neoplasms of uncertain behavior, polycythemia vera and myelodysplastic syndromes (D37-D48)
D48.4
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceNeoplasm of uncertain behavior of peritoneum
A growth in the peritoneum (the lining of the abdominal cavity) that is not clearly cancer but has uncertain behavior.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialNo inclusion terms are included in this display for D48.4. Check the code and parent instructions in the Code Book.
Excludes 2
OfficialNo Excludes 2 notes are included in this display for D48.4. Check the code and parent instructions in the Code Book.
Related Codes
Includes
OfficialNo Includes notes are included in this display for D48.4. Check the code and parent instructions in the Code Book.
Excludes 1
Official- neoplasms of unspecified behavior (D49.-)Inherited from D37-D48, D48
- neurofibromatosis (nonmalignant) (Q85.0-)Inherited from D37-D48, D48
Code First
OfficialNo Code First sequencing instructions are included in this display for D48.4. Check the code and parent instructions in the Code Book.
Use Additional
OfficialNo Use Additional Code instructions are included in this display for D48.4. Check the code and parent instructions in the Code Book.
Code Also
OfficialNo Code Also instructions are included in this display for D48.4. Check the code and parent instructions in the Code Book.
Buddy Documentation Tip
Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →
Is D48.4 an HCC code?
No. D48.4 is a billable ICD-10-CM code with no mapping under the current CMS-HCC V28 community payment model, and none under the ESRD, Part D RxHCC, or HHS-HCC models.
- Code
- D48.4
- Description
- Neoplasm of uncertain behavior of peritoneum
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF reference coefficient
- —
- Billable
- Yes
- Payment year
- 2026
Coder workflow notes
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What This Code Means
D48.4 is the ICD-10-CM diagnosis code for neoplasm of uncertain behavior of peritoneum. A growth in the peritoneum (the lining of the abdominal cavity) that is not clearly cancer but has uncertain behavior. D48.4 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).
D48.4 is a billable ICD-10-CM code, but no current CMS-HCC V28 community payment mapping is shown, and none under the ESRD, Part D RxHCC, or HHS-HCC models. Do not assign risk adjustment value from this page when no source-backed mapping is shown; verify the applicable model and payment year.
Peritoneal tumors may be difficult to distinguish from metastatic disease; ensure pathology confirms primary peritoneal origin.
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for D48.4 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Peritoneal tumors may be difficult to distinguish from metastatic disease; ensure pathology confirms primary peritoneal origin
- •Document whether the tumor is localized or diffuse across the peritoneal surface