ICD-10 D33.1
Billable / Specific HCC v28: 12Benign neoplasm of brain, infratentorial
About ICD-10-CM D33.1
ICD-10-CM code D33.1 represents Benign neoplasm of brain, infratentorial. This is a billable/specific code in the Neoplasms chapter (block D33). The 2026 edition of ICD-10-CM D33.1 became effective on October 1, 2025.
Coding Tips for D33.1
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
D33.1 is a CMS-HCC v28 risk-adjustment code (category 12). To count for the patient Risk Adjustment Factor (RAF), document the diagnosis with MEAT language each calendar year: Monitored, Evaluated, Assessed, Treated. A diagnosis on the problem list alone does not satisfy CMS RADV audit standards. Include the diagnosis in the assessment with current status and current treatment plan.
Inclusion Terms / Approximate Synonyms
Clinical terms and conditions classified under D33.1. Per CMS ICD-10-CM Tabular 2026.
- Benign neoplasm of brain stem
- Benign neoplasm of cerebellum
- Benign neoplasm of fourth ventricle
Medicare Advantage HCC Impact
Capture this diagnosis annually for accurate risk adjustment. Missed HCC captures are the #1 revenue leak in Medicare Advantage risk programs.
Medicare LCD Coverage for D33.1
Local Coverage Determinations (LCDs) from CMS MACs that list D33.1 as a covered diagnosis.
Showing top 10 of 487 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing D33.1.
5 Medicare
CPT Codes Commonly Billed with D33.1
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 95926 CMS LCD: Billing and Coding: Somatosensory Testing CMS LCD
- 95925 CMS LCD: Billing and Coding: Somatosensory Testing CMS LCD
- 95938 CMS LCD: Billing and Coding: Somatosensory Testing CMS LCD
- 95927 CMS LCD: Billing and Coding: Somatosensory Testing CMS LCD
- 95929 CMS LCD: Billing and Coding: Neurophysiology Evoked Potentials (NEPs) CMS LCD
- 92651 CMS LCD: Billing and Coding: Neurophysiology Evoked Potentials (NEPs) CMS LCD
- 92653 CMS LCD: Billing and Coding: Neurophysiology Evoked Potentials (NEPs) CMS LCD
- 95928 CMS LCD: Billing and Coding: Neurophysiology Evoked Potentials (NEPs) CMS LCD
- 95930 CMS LCD: Billing and Coding: Neurophysiology Evoked Potentials (NEPs) CMS LCD
- 92652 CMS LCD: Billing and Coding: Neurophysiology Evoked Potentials (NEPs) CMS LCD
Convert D33.1 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| D33.1 | 2250 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To D33.1
Other codes in section D10-D36 (Benign neoplasms, except benign neuroendocrine tumors).
ICD-10 D33.1, Billing FAQ
Is ICD-10 code D33.1 billable? +
Yes, D33.1 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
What other names or terms map to D33.1? +
ICD-10 D33.1 includes: Benign neoplasm of brain stem; Benign neoplasm of cerebellum; Benign neoplasm of fourth ventricle.
Does D33.1 affect Medicare Advantage HCC risk adjustment? +
Yes. D33.1 maps to CMS-HCC v28 category 12. Capture this diagnosis annually for accurate Medicare Advantage risk score.
What CPT codes are commonly billed with D33.1? +
Procedures frequently paired with D33.1 include: 95926, 95925, 95938, 95927, 95929.
What ICD-9 codes does D33.1 map to? +
Per CMS GEMs, D33.1 maps to ICD-9 codes: 2250. Useful for legacy data review and historical claim analysis.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on July 16, 2026.
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