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

ICD-10 D40.0

Billable / Specific

Neoplasm of uncertain behavior of prostate

D40
Block
0
Synonyms
259
LCDs
24
Payer Policies
11
Linked CPTs

About ICD-10-CM D40.0

ICD-10-CM code D40.0 represents Neoplasm of uncertain behavior of prostate. This is a billable/specific code in the Neoplasms chapter (block D40). The 2026 edition of ICD-10-CM D40.0 became effective on October 1, 2025.

Medicare LCD Coverage for D40.0

Local Coverage Determinations (LCDs) from CMS MACs that list D40.0 as a covered diagnosis.

259 LCDs

Showing top 10 of 259 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Transrectal Ultrasound
Article ID: 57427, Effective: 2024-10-01 00:00:00, 118 covered, 0 non-covered
CPT 76872 →
CMS LCD: Billing and Coding: Transrectal Ultrasound
Article ID: 57427, Effective: 2024-10-01 00:00:00, 118 covered, 0 non-covered
CPT 76873 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74170 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74177 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74160 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74178 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74150 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 72194 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74176 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 72192 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing D40.0.

24 policies

1 Aetna

Transrectal Ultrasound - Medical Clinical Policy Bulletins | Aetna
Policy ID: CPB-0001

5 Medicare

Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) - Policy Article
Policy ID: ART-52480
Billing and Coding: Biomarkers for Oncology
Policy ID: ART-52986
Billing and Coding: Lab: Flow Cytometry
Policy ID: ART-55717
Billing and Coding: CT of the Abdomen and Pelvis
Policy ID: ART-56421
Billing and Coding: Erythropoiesis Stimulating Agents (ESA)
Policy ID: ART-56462

CPT Codes Commonly Billed with D40.0

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

11 linkages
  • 51741 CMS LCD: Billing and Coding: Urodynamics CMS LCD
  • 51728 CMS LCD: Billing and Coding: Urodynamics CMS LCD
  • 51729 CMS LCD: Billing and Coding: Urodynamics CMS LCD
  • 55899 CMS LCD: Billing and Coding: Urodynamics CMS LCD
  • 51792 CMS LCD: Billing and Coding: Urodynamics CMS LCD
  • 51736 CMS LCD: Billing and Coding: Urodynamics CMS LCD
  • 51726 CMS LCD: Billing and Coding: Urodynamics CMS LCD
  • 51727 CMS LCD: Billing and Coding: Urodynamics CMS LCD
  • 51797 CMS LCD: Billing and Coding: Urodynamics CMS LCD
  • 76873 CMS LCD: Billing and Coding: Transrectal Ultrasound CMS LCD

Convert D40.0 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
D40.0 2365 00000

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

ICD-10 D40.0, Billing FAQ

Is ICD-10 code D40.0 billable? +

Yes, D40.0 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What CPT codes are commonly billed with D40.0? +

Procedures frequently paired with D40.0 include: 51741, 51728, 51729, 55899, 51792.

What ICD-9 codes does D40.0 map to? +

Per CMS GEMs, D40.0 maps to ICD-9 codes: 2365. 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 May 31, 2026.

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