2027 ICD-10-CM Diagnosis Code D43.0Neoplasm of uncertain behavior of brain, supratentorial

ICD-10-CM Codes›C00–D49›D37-D48›D43

ICD-10-CM D43.0
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

D43.0 is a billable ICD-10-CM diagnosis code for neoplasm of uncertain behavior of brain, supratentorial. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 54 through 55. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Neoplasms of unspecified nature or uncertain behavior.

For Medicare Advantage risk adjustment, D43.0 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

ICD-10-CM Code
D43.0
Billable Status
Yes — Valid for Submission
Code Describes
Neoplasm of uncertain behavior of brain, supratentorial
Short Description
Neoplasm of uncertain behavior of brain, supratentorial
Same as the full description in the CMS dataset.
Parent Code
D43
Neoplasm of uncertain behavior of brain and central nervous system

Code Classification

ChapterC00–D49Neoplasms
SectionD37-D48Neoplasms of uncertain behavior, polycythemia vera and myelodysplastic syndromes
CategoryD43Neoplasm of uncertain behavior of brain and central nervous system
This CodeD43.0Neoplasm of uncertain behavior of brain, supratentorial

Medicare Risk Adjustment (HCC)Billing

D43.0 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 23— Prostate, Breast, and Other Cancers and Tumors
Payment HCC · PY 2027 one of 234 ICD-10-CM codes in this category
Risk Adjustment Factor (RAF) Weight
+0.186
community, non-dual, aged · ranges 0.186–0.237 across segments
Hierarchy
Superseded by HCC 17, HCC 18, HCC 19, HCC 20, HCC 21, and HCC 22
a more severe related category takes the payment when both are reported
Prior Model (CMS-HCC V24)
HCC 12
V24 retired V28 pays 100% of MA risk scores since PY 2026
Other CMS Models
PACE (CMS-HCC V22): HCC 12 · ESRD (V21): HCC 12 · ESRD (V24): HCC 12
ESRD V21 weights: 0.046 dialysis, 0.156–0.194 functioning graft · ESRD V24 weights: 0.045 dialysis, 0.162–0.219 functioning graft
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.

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Atypical papilloma of choroid plexus
  • Desmoplastic infantile astrocytoma and ganglioglioma
  • Hemangioblastoma of central nervous system
  • Hemangioblastoma of cerebrum
  • Neoplasm of choroid plexus
  • Neoplasm of hypothalamus
  • Neoplasm of uncertain behavior of brain ventricle
  • Neoplasm of uncertain behavior of cerebrum
  • Neoplasm of uncertain behavior of frontal lobe
  • Neoplasm of uncertain behavior of hypothalamus
  • Neoplasm of uncertain behavior of occipital lobe
  • Neoplasm of uncertain behavior of parietal lobe
  • Neoplasm of uncertain behavior of temporal lobe
  • Neoplasm of uncertain or unknown behavior of brain, supratentorial

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to D43.0: its own notes plus those printed at D43, block D37-D48, and Chapter 2. A note printed at a category, block or chapter applies to every code under it.

Applicable To

Conditions this code is used for: synonyms of the title or, for "other specified" codes, the conditions assigned to it. The list is not exhaustive.

  • Neoplasm of uncertain behavior of cerebral ventricle
  • Neoplasm of uncertain behavior of cerebrum
  • Neoplasm of uncertain behavior of frontal lobe
  • Neoplasm of uncertain behavior of occipital lobe
  • Neoplasm of uncertain behavior of parietal lobe
  • Neoplasm of uncertain behavior of temporal lobe

Excludes1

Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.

On D43.0 itself
  • neoplasm of uncertain behavior of fourth ventricle (D43.1)
From D43 Neoplasm of uncertain behavior of brain and central nervous system applies to 7 codes
  • neoplasm of uncertain behavior of peripheral nerves and autonomic nervous system (D48.2)
From Block D37-D48 Neoplasms of uncertain behavior, polycythemia vera and myelodysplastic syndromes applies to 137 codes
  • neoplasms of unspecified behavior (D49.-)

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 D43.0, its category, or a range that includes it.

Excludes2 1

These codes carry an Excludes2 note naming D43.0: 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 D43.0.

  • 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

Clinical ClassificationClinical

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

CCSR NEO072
Neoplasms of unspecified nature or uncertain behavior
Default principal diagnosis: inpatient Yes · outpatient Yes

Clinical InformationClinical

  • Supratentorial Neoplasm

    a benign or malignant neoplasm that occurs within the intracranial cavity above the tentorium cerebelli.

Table of NeoplasmsClinical

Anatomical sites in the Table of Neoplasms that reference this code family.

SiteMalig.
Primary		Malig.
Secondary		Ca
in situ		BenignUncertainUnspec.
basal gangliaC71.0C79.31–D33.0D43.0D49.6
brain NEC › basal gangliaC71.0C79.31–D33.0D43.0D49.6
brain NEC › cerebrumC71.0C79.31–D33.0D43.0D49.6
brain NEC › corpus striatumC71.0C79.31–D33.0D43.0D49.6
brain NEC › cortex (cerebral)C71.0C79.31–D33.0D43.0D49.6
brain NEC › frontal lobeC71.1C79.31–D33.0D43.0D49.6
brain NEC › globus pallidusC71.0C79.31–D33.0D43.0D49.6
brain NEC › hippocampusC71.2C79.31–D33.0D43.0D49.6
brain NEC › hypothalamusC71.0C79.31–D33.0D43.0D49.6
brain NEC › internal capsuleC71.0C79.31–D33.0D43.0D49.6
brain NEC › occipital lobeC71.4C79.31–D33.0D43.0D49.6
brain NEC › parietal lobeC71.3C79.31–D33.0D43.0D49.6
brain NEC › temporal lobeC71.2C79.31–D33.0D43.0D49.6
brain NEC › thalamusC71.0C79.31–D33.0D43.0D49.6
brain NEC › uncusC71.2C79.31–D33.0D43.0D49.6
brain NEC › ventricle (floor)C71.5C79.31–D33.0D43.0D49.6
cerebrum, cerebral (cortex) (hemisphere) (white matter)C71.0C79.31–D33.0D43.0D49.6
cerebrum, cerebral (cortex) (hemisphere) (white matter) › ventricleC71.5C79.31–D33.0D43.0D49.6
choroid › plexusC71.5C79.31–D33.0D43.0D49.6
corpus › striatum, cerebrumC71.0C79.31–D33.0D43.0D49.6
cortex › cerebralC71.0C79.31–D33.0D43.0D49.6
ependyma (brain)C71.5C79.31–D33.0D43.0D49.6
frontal › lobe, brainC71.1C79.31–D33.0D43.0D49.6
frontal › poleC71.1C79.31–D33.0D43.0D49.6
ganglia [See Also: Neoplasm, nerve, peripheral] › basalC71.0C79.31–D33.0D43.0D49.6
globus pallidusC71.0C79.31–D33.0D43.0D49.6
hemisphere, cerebralC71.0C79.31–D33.0D43.0D49.6
hippocampus, brainC71.2C79.31–D33.0D43.0D49.6
hypothalamusC71.0C79.31–D33.0D43.0D49.6
insulaC71.0C79.31–D33.0D43.0D49.6
insular tissue (pancreas) › brainC71.0C79.31–D33.0D43.0D49.6
internal › capsuleC71.0C79.31–D33.0D43.0D49.6
island of ReilC71.0C79.31–D33.0D43.0D49.6
occipital › lobe or pole, brainC71.4C79.31–D33.0D43.0D49.6
operculum (brain)C71.0C79.31–D33.0D43.0D49.6
palliumC71.0C79.31–D33.0D43.0D49.6
parietal › lobe, brainC71.3C79.31–D33.0D43.0D49.6
plexus › choroidC71.5C79.31–D33.0D43.0D49.6
pole › frontalC71.1C79.31–D33.0D43.0D49.6
pole › occipitalC71.4C79.31–D33.0D43.0D49.6
putamenC71.0C79.31–D33.0D43.0D49.6
rhinencephalonC71.0C79.31–D33.0D43.0D49.6
supratentorial (brain) NECC71.0C79.31–D33.0D43.0D49.6
temporal › lobe or poleC71.2C79.31–D33.0D43.0D49.6
thalamusC71.0C79.31–D33.0D43.0D49.6
uncus, brainC71.2C79.31–D33.0D43.0D49.6
ventricle (cerebral) (floor) (lateral) (third)C71.5C79.31–D33.0D43.0D49.6
white matter (central) (cerebral)C71.0C79.31–D33.0D43.0D49.6

Patient EducationClinical

Brain Diseases

Your brain is the control center of your body. It controls your thoughts, memory, speech, and movement. It regulates the function of many organs. It's part of your nervous system, which also includes your spinal cord and peripheral nerves. The nervous system sends signals between your brain and the rest of the body.

Read the full article at MedlinePlus

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Convert D43.0 to ICD-9-CMHistory

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

ICD-9-CM
237.5 Unc beh neo brain/spinal
Approximate The match is approximate rather than exact.

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 D43.0Overview

What is the ICD-10 code for neoplasm of uncertain behavior of brain, supratentorial?

The ICD-10-CM code for neoplasm of uncertain behavior of brain, supratentorial is D43.0 (sometimes written as D430). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is D43.0 a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report neoplasm of uncertain behavior of brain, supratentorial on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does D43.0 group to?

When neoplasm of uncertain behavior of brain, supratentorial is the principal diagnosis on an inpatient stay, it groups to MS-DRG 55, 54, with relative weights from 1.0291 to 1.5197 depending on complications. Higher weights mean higher Medicare reimbursement.

Can D43.0 be reported with D43.1?

Not as a rule. The Excludes1 note on D43.0 lists "neoplasm of uncertain behavior of fourth ventricle (D43.1)". 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).

What is the ICD-9 equivalent of D43.0?

Under the General Equivalence Mappings, neoplasm of uncertain behavior of brain, supratentorial converts to ICD-9-CM 237.5 (unc beh neo brain/spinal). The mapping is approximate, so confirm the match fits the documentation.

What HCC is D43.0?

D43.0 (neoplasm of uncertain behavior of brain, supratentorial) 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 D43.0 risk-adjust for Medicare Advantage payment?

Yes. When documented and reported on a Medicare Advantage encounter, D43.0 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.