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

ICD-10 D43

Non-Billable Header

Neoplasm of uncertain behavior of brain and central nervous system

D43
Block
0
Synonyms
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LCDs
0
Payer Policies
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Linked CPTs

About ICD-10-CM D43

ICD-10-CM code D43 represents Neoplasm of uncertain behavior of brain and central nervous system. This is a non-billable header code in the Neoplasms chapter (block D43). The 2026 edition of ICD-10-CM D43 became effective on October 1, 2025. Non-billable codes cannot be used as a primary or secondary diagnosis on a claim, use a more specific child code instead.

Type 1 Excludes

Pure excludes, these codes can never be coded together with D43. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • neoplasm of uncertain behavior of peripheral nerves and autonomic nervous system (D48.2)

Medicare LCD Coverage for D43

Local Coverage Determinations (LCDs) from CMS MACs that list D43 as a covered diagnosis.

No Medicare LCDs reference D43 as covered

This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.

Commercial Payer Coverage

Coverage policies from major commercial payers referencing D43.

No commercial payer policies reference D43 on file

Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but D43 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.

CPT Codes Commonly Billed with D43

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

No procedure linkages on file for D43

We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.

ICD-10 D43, Billing FAQ

Is ICD-10 code D43 billable? +

No, D43 is a non-billable header code. Use a more specific child code from block D43 when submitting claims.

What codes are Type 1 Excludes for D43? +

Type 1 Excludes (never code together with D43): neoplasm of uncertain behavior of peripheral nerves and autonomic nervous system (D48.2)

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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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