ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 D35.2

Billable / Specific HCC v28: 12

Benign neoplasm of pituitary gland

D35
Block
0
Synonyms
292
LCDs
28
Payer Policies
9
Linked CPTs

About ICD-10-CM D35.2

ICD-10-CM code D35.2 represents Benign neoplasm of pituitary gland. This is a billable/specific code in the Neoplasms chapter (block D35). The 2026 edition of ICD-10-CM D35.2 became effective on October 1, 2025.

Coding Tips for D35.2

Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.

HCC capture: document with MEAT each year

D35.2 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.

Medicare Advantage HCC Impact

CMS-HCC v28 (current)
Category 12
ESRD-HCC
Category 12
RxHCC (Part D)
Category 12

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 D35.2

Local Coverage Determinations (LCDs) from CMS MACs that list D35.2 as a covered diagnosis.

292 LCDs

Showing top 10 of 292 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Radiation Therapies
Article ID: 59350, Effective: 2026-01-01 00:00:00, 757 covered, 0 non-covered
CPT 77402 →
CMS LCD: Billing and Coding: Radiation Therapies
Article ID: 59350, Effective: 2026-01-01 00:00:00, 757 covered, 0 non-covered
CPT 77371 →
CMS LCD: Billing and Coding: Radiation Therapies
Article ID: 59350, Effective: 2026-01-01 00:00:00, 757 covered, 0 non-covered
CPT 61797 →
CMS LCD: Billing and Coding: Radiation Therapies
Article ID: 59350, Effective: 2026-01-01 00:00:00, 757 covered, 0 non-covered
CPT G0339 →
CMS LCD: Billing and Coding: Radiation Therapies
Article ID: 59350, Effective: 2026-01-01 00:00:00, 757 covered, 0 non-covered
CPT 77338 →
CMS LCD: Billing and Coding: Radiation Therapies
Article ID: 59350, Effective: 2026-01-01 00:00:00, 757 covered, 0 non-covered
CPT 77432 →
CMS LCD: Billing and Coding: Radiation Therapies
Article ID: 59350, Effective: 2026-01-01 00:00:00, 757 covered, 0 non-covered
CPT 61800 →
CMS LCD: Billing and Coding: Radiation Therapies
Article ID: 59350, Effective: 2026-01-01 00:00:00, 757 covered, 0 non-covered
CPT 77372 →
CMS LCD: Billing and Coding: Radiation Therapies
Article ID: 59350, Effective: 2026-01-01 00:00:00, 757 covered, 0 non-covered
CPT 77435 →
CMS LCD: Billing and Coding: Radiation Therapies
Article ID: 59350, Effective: 2026-01-01 00:00:00, 757 covered, 0 non-covered
CPT 77407 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing D35.2.

28 policies

1 Cigna

Diagnostic Nasal/Sinus Endoscopy, Functional Endoscopic Sinus Surgery (FESS) and Turbinectomy - (0554)
Policy ID: MM_0554

5 Medicare

Billing and Coding: Proton Beam Therapy
Policy ID: ART-55315
Billing and Coding: Flow Cytometry
Policy ID: ART-56464
Billing and Coding: Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)
Policy ID: ART-56537
Billing and Coding: Visual Fields Testing
Policy ID: ART-56551
Billing and Coding: Computerized Axial Tomography (CT), Thorax
Policy ID: ART-56580

CPT Codes Commonly Billed with D35.2

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

9 linkages
  • J3145 CMS LCD: Billing and Coding: Treatment of Males with Low Testosterone CMS LCD
  • 84403 CMS LCD: Billing and Coding: Treatment of Males with Low Testosterone CMS LCD
  • 84410 CMS LCD: Billing and Coding: Treatment of Males with Low Testosterone CMS LCD
  • J1072 CMS LCD: Billing and Coding: Treatment of Males with Low Testosterone CMS LCD
  • 11980 CMS LCD: Billing and Coding: Treatment of Males with Low Testosterone CMS LCD
  • J1071 CMS LCD: Billing and Coding: Treatment of Males with Low Testosterone CMS LCD
  • J3121 CMS LCD: Billing and Coding: Treatment of Males with Low Testosterone CMS LCD
  • 73225 CMS LCD: Billing and Coding: Magnetic Resonance Angiography (MRA) CMS LCD
  • 72159 CMS LCD: Billing and Coding: Magnetic Resonance Angiography (MRA) CMS LCD

Convert D35.2 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
D35.2 2273 10000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 D35.2, Billing FAQ

Is ICD-10 code D35.2 billable? +

Yes, D35.2 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

Does D35.2 affect Medicare Advantage HCC risk adjustment? +

Yes. D35.2 maps to CMS-HCC v28 category 12. Capture this diagnosis annually for accurate Medicare Advantage risk score.

What CPT codes are commonly billed with D35.2? +

Procedures frequently paired with D35.2 include: J3145, 84403, 84410, J1072, 11980.

What ICD-9 codes does D35.2 map to? +

Per CMS GEMs, D35.2 maps to ICD-9 codes: 2273. 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 June 1, 2026.

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