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v1.0.0
ICD-10 Guide
DiagnosesAtypical Nevus

Atypical Nevus

ICD-10 Coding for Atypical Nevus(D22.X, D48.5)

PRIMARY SPECIALTYDermatology
COMPLEXITYHigh
LAST UPDATED09/15/2025
Sam Tuffun, PT, DPT
Physical Therapist | Medical Coding & Billing Contributor

Diagnosis Overview

What is Atypical Nevus?
Essential facts and insights about Atypical Nevus

Key Clinical Considerations:

  • Irregular borders and color variations in the nevus
  • Dermatoscopic examination showing atypical features
  • Presence of multiple atypical nevi in the patient

Clinical Information

Clinical Criteria & Documentation Requirements

  • Patient history including family history of melanoma
  • Detailed description of the nevus characteristics
  • Photographic documentation of the lesion

Coding Guidelines

Usage Guidelines & Examples

  • Follow guidelines for distinguishing between atypical nevi and melanoma.
  • Common errors include misclassifying atypical nevi as benign.

Code Exclusions

Important Exclusions

  • Melanoma (C43)
  • Benign nevi (D22.0-D22.8)

Related ICD-10 Codes

Primary Codes
D22.9
Melanocytic neoplasm of uncertain behavior, unspecified
Ancillary Codes
D22.5
D48.5
.
Differential Codes
D48.5
D22.X

Related CPT Codes

CPT codes will be available in a future update.

Specialty Focus

Primary Specialty

Dermatology

Specialty Applications

  • Patients with a family history of skin cancer
  • Dermatology clinics and outpatient settings

Coding Complexity

High Complexity

This diagnosis requires careful attention to:

  • Comprehensive clinical documentation
  • Accurate code selection based on clinical criteria
  • Proper exclusion considerations
  • Specialty-specific coding guidelines

Documentation

Documentation Templates

Billing Information

Billing Considerations

  • Ensure proper documentation for billing
  • Verify code specificity requirements
  • Check for any additional codes needed
  • Review payer-specific guidelines

Common Issues

  • Insufficient clinical documentation
  • Incorrect code selection
  • Missing supporting diagnoses
  • Timing and frequency documentation

Frequently Asked Questions

What are the documentation requirements?

Document the size, shape, color, and any changes in the nevus.

What are the billing considerations?

Ensure accurate coding to reflect the complexity of the lesion and any associated procedures.