2027 ICD-10-CM Diagnosis Code D35.3Benign neoplasm of craniopharyngeal duct
ICD-10-CM Codes›C00–D49›D10-D36›D35
- Billable — Valid for Submission
- Risk Adjusts — HCC 23
- Not Chronic
D35.3 is a billable ICD-10-CM diagnosis code for benign neoplasm of craniopharyngeal duct. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 643 through 645. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Benign neoplasms.
For Medicare Advantage risk adjustment, D35.3 maps to CMS-HCC Category 23 (Prostate, Breast, and Other Cancers and Tumors) under the V28 model, adding a risk factor of about 0.186 for a community, non-dual, aged beneficiary in payment year 2027.
Code Identity
Code Classification
Medicare Risk Adjustment (HCC)Billing
D35.3 maps to a payment category in the CMS-HCC model used to risk-adjust Medicare Advantage payments. Weights are the published community factors for payment year 2027.
Source: CMS Payment Year 2027 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Benign neoplasm of craniopharyngeal duct
- Benign neoplasm of pituitary gland and craniopharyngeal duct
- Neoplasm of craniopharyngeal duct
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to D35.3: its own notes plus those printed at D35 and Chapter 2. A note printed at a category, block or chapter applies to every code under it.
Excludes1
Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.
Use Additional Code
Add a second code, after this one, to fully describe the condition.
- code to identify any functional activity
Notes
General instructions on how these codes are used.
- Functional activity
- All neoplasms are classified in this chapter, whether they are functionally active or not. An additional code from Chapter 4 may be used, to identify functional activity associated with any neoplasm.
- Morphology [Histology]
- Chapter 2 classifies neoplasms primarily by site (topography), with broad groupings for behavior, malignant, in situ, benign, etc. The Table of Neoplasms should be used to identify the correct topography code. In a few cases, such as for malignant melanoma and certain neuroendocrine tumors, the morphology (histologic type) is included in the category and codes.
- Primary malignant neoplasms overlapping site boundaries
- A primary malignant neoplasm that overlaps two or more contiguous (next to each other) sites should be classified to the subcategory/code .8 ('overlapping lesion'), unless the combination is specifically indexed elsewhere. For multiple neoplasms of the same site that are not contiguous, such as tumors in different quadrants of the same breast, codes for each site should be assigned.
- Malignant neoplasm of ectopic tissue
- Malignant neoplasms of ectopic tissue are to be coded to the site mentioned, e.g., ectopic pancreatic malignant neoplasms are coded to pancreas, unspecified (C25.9).
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Clinical InformationClinical
Craniopharyngioma
a benign, partly cystic, epithelial tumor of the sellar region, presumably derived from rathke pouch epithelium. it affects mainly children and young adults. there are two clinicopathological forms: adamantinomatous craniopharyngioma and papillary craniopharyngioma. the most significant factor associated with recurrence is the extent of surgical resection, with lesions greater than 5 cm in diameter carrying a markedly worse prognosis. (adapted from who)
Table of NeoplasmsClinical
Patient EducationClinical
Benign Tumors
Tumors are abnormal growths in your body. They can be either benign or malignant. Benign tumors aren't cancer. Malignant ones are. Benign tumors grow only in one place. They cannot spread or invade other parts of your body. Even so, they can be dangerous if they press on vital organs, such as your brain.
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert D35.3 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About D35.3Overview
What is the ICD-10 code for benign neoplasm of craniopharyngeal duct?
The ICD-10-CM code for benign neoplasm of craniopharyngeal duct is D35.3 (sometimes written as D353). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is D35.3 (Benign neoplasm of other and unspecified endocrine glands) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report benign neoplasm of craniopharyngeal duct on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does D35.3 group to?
When benign neoplasm of craniopharyngeal duct is the principal diagnosis on an inpatient stay, it groups to MS-DRG 644, 645, 643, with relative weights from 0.7461 to 1.6138 depending on complications. Higher weights mean higher Medicare reimbursement.
Can D35.3 be reported with D13.7?
Not as a rule. The Excludes1 note at D35, which applies to D35.3, lists "benign neoplasm of endocrine pancreas (D13.7)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).
Does D35.3 need an additional code?
When the condition applies, yes. The Use Additional Code note at D35, which applies to D35.3, reads: code to identify any functional activity. The additional code is reported after D35.3.
What HCC is D35.3?
D35.3 (benign neoplasm of craniopharyngeal duct) maps to CMS-HCC Category 23 (Prostate, Breast, and Other Cancers and Tumors), commonly written as HCC 23, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2027. It mapped to HCC 12 under the retired V24 model. It also maps in the PACE (CMS-HCC V22), ESRD (V21), and ESRD (V24) models. In the Part D prescription drug model it maps to RxHCC 22.
Does D35.3 risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, D35.3 adds a risk adjustment factor of about 0.186 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.186 to 0.237 depending on the payment segment). A more severe related category (HCC 17, HCC 18, HCC 19, HCC 20, HCC 21, and HCC 22) supersedes it when both are reported. See the full factor table on the HCC 23 category page.
