2027 ICD-10-CM Diagnosis Code D3A.019Benign carcinoid tumor of the small intestine, unspecified portion

ICD-10-CM Codes›C00–D49›D3A›D3A

ICD-10-CM D3A.019
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

D3A.019 is a billable ICD-10-CM diagnosis code for benign carcinoid tumor of the small intestine, unspecified portion. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 393 through 395. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Benign neoplasms.

For Medicare Advantage risk adjustment, D3A.019 maps to CMS-HCC Category 22 (Bladder, Colorectal, and Other Cancers) under the V28 model, adding a risk factor of about 0.363 for a community, non-dual, aged beneficiary in payment year 2027.

Code Identity

ICD-10-CM Code
D3A.019
Billable Status
Yes — Valid for Submission
Code Describes
Benign carcinoid tumor of the small intestine, unspecified portion
Short Description
Benign carcinoid tumor of the small intestine, unsp portion
Parent Code
D3A.01
Benign carcinoid tumors of the small intestine

Code Classification

ChapterC00–D49Neoplasms
SectionD3ABenign neuroendocrine tumors
CategoryD3ABenign neuroendocrine tumors
This CodeD3A.019Benign carcinoid tumor of the small intestine, unspecified portion

Medicare Risk Adjustment (HCC)Billing

D3A.019 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.

CMS-HCC V28 Category (Payment Model)
HCC 22— Bladder, Colorectal, and Other Cancers
Payment HCC · PY 2027 one of 126 ICD-10-CM codes in this category
Risk Adjustment Factor (RAF) Weight
+0.363
community, non-dual, aged · ranges 0.314–0.410 across segments
Hierarchy
Superseded by HCC 17, HCC 18, HCC 19, HCC 20, and HCC 21
a more severe related category takes the payment when both are reported
Prior Model (CMS-HCC V24)
Not mapped under V24
this diagnosis newly risk-adjusts under the V28 model
Part D (RxHCC)
RxHCC 22 — Prostate, Breast, Bladder, and Other Cancers and Tumors
also risk-adjusts in the Part D prescription drug model (V08)

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.

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to D3A.019: its own notes plus those printed at D3A, block D37-D48, 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.

From Block D37-D48 Neoplasms of uncertain behavior, polycythemia vera and myelodysplastic syndromes applies to 137 codes
  • neoplasms of unspecified behavior (D49.-)

Excludes2

Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.

From D3A Benign neuroendocrine tumors applies to 22 codes
  • benign pancreatic islet cell tumors (D13.7)

Use Additional Code

Add a second code, after this one, to fully describe the condition.

From D3A Benign neuroendocrine tumors applies to 22 codes
  • code to identify any associated endocrine syndrome, such as:
  • carcinoid syndrome (E34.00)

Code Also

A second code may be needed to fully describe the condition; the note gives no sequencing direction.

From D3A Benign neuroendocrine tumors applies to 22 codes
  • any associated multiple endocrine neoplasia [MEN] syndromes (E31.2-)

Notes

General instructions on how these codes are used.

From Block D37-D48 Neoplasms of uncertain behavior, polycythemia vera and myelodysplastic syndromes applies to 137 codes
  • Categories D37-D44, and D48 classify by site neoplasms of uncertain behavior, i.e., histologic confirmation whether the neoplasm is malignant or benign cannot be made.
From Chapter 2 (C00-D49) Neoplasms applies to 1,730 codes
  • 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.

Referenced in Other NotesGuidance

Instructional notes printed at other codes that name D3A.019, its category, or a range that includes it.

Excludes1 1

These codes carry an Excludes1 note naming D3A.019: they are not reported together with it, unless the two conditions are unrelated.

  • D13.3 Benign neoplasm of other and unspecified parts of small intestine
    benign carcinoid tumors of the small intestine (D3A.01-) names D3A.01-, which includes this code

Excludes2 1

These codes carry an Excludes2 note naming D3A.019: its condition is not part of those codes, and both may be reported when the patient has both.

  • D49 Neoplasms of unspecified behavior
    neoplasms of uncertain behavior (D37-D44, D48) names D37-D44, which includes this code

Notes 1

These notes mention D3A.019.

  • Block D37-D48 Neoplasms of uncertain behavior, polycythemia vera and myelodysplastic syndromes
    Categories D37-D44, and D48 classify by site neoplasms of uncertain behavior, i.e., histologic confirmation whether the neoplasm is malignant or benign cannot be made. names D37-D44, which includes this code

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR NEO073
Benign neoplasms
Default principal diagnosis: inpatient Yes · outpatient Yes

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 D3A.019 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
209.40 Ben crcnoid sm intst NOS
Exact Match The mapping is direct, with no qualifiers.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About D3A.019Overview

What is the ICD-10 code for benign carcinoid tumor of the small intestine, unspecified portion?

The ICD-10-CM code for benign carcinoid tumor of the small intestine, unspecified portion is D3A.019 (sometimes written as D3A019). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is D3A.019 (Benign carcinoid tumors of the small intestine) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report benign carcinoid tumor of the small intestine, unspecified portion on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does D3A.019 group to?

When benign carcinoid tumor of the small intestine, unspecified portion is the principal diagnosis on an inpatient stay, it groups to MS-DRG 394, 395, 393, with relative weights from 0.6379 to 1.5877 depending on complications. Higher weights mean higher Medicare reimbursement.

Can D3A.019 be reported with a code from D49?

Not as a rule. The Excludes1 note at block D37-D48, which applies to D3A.019, lists "neoplasms of unspecified behavior (D49.-)". 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 D3A.019 need an additional code?

When the condition applies, yes. The Use Additional Code note at D3A, which applies to D3A.019, reads: code to identify any associated endocrine syndrome, such as: carcinoid syndrome (E34.00). The additional code is reported after D3A.019.

What HCC is D3A.019?

D3A.019 (benign carcinoid tumor of the small intestine, unspecified portion) maps to CMS-HCC Category 22 (Bladder, Colorectal, and Other Cancers), commonly written as HCC 22, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2027. In the Part D prescription drug model it maps to RxHCC 22.

Does D3A.019 risk-adjust for Medicare Advantage payment?

Yes. When documented and reported on a Medicare Advantage encounter, D3A.019 adds a risk adjustment factor of about 0.363 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.314 to 0.410 depending on the payment segment). A more severe related category (HCC 17, HCC 18, HCC 19, HCC 20, and HCC 21) supersedes it when both are reported. See the full factor table on the HCC 22 category page.