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ICD-10 Guide
ICD-10 CodesD01.2

D01.2

Billable

Carcinoma in situ of rectum

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 D01.2 is a billable code used to indicate a diagnosis of carcinoma in situ of rectum.

Key Diagnostic Point:

Carcinoma in situ of the rectum refers to a localized form of cancer where abnormal cells are present in the rectal mucosa but have not invaded deeper tissues or metastasized to other parts of the body. This condition is characterized by the presence of atypical cells that exhibit malignant features but remain confined to the site of origin. Early detection through screening methods such as colonoscopy is crucial, as it allows for timely intervention and management. The prognosis for patients diagnosed with carcinoma in situ is generally favorable, especially when detected early. Treatment options may include local excision, endoscopic resection, or surveillance protocols, depending on the extent of the lesion and patient factors. Regular follow-up is essential to monitor for any signs of progression to invasive cancer, which can occur if left untreated. Surveillance protocols typically involve periodic colonoscopy and imaging studies to ensure that any changes in the rectal tissue are promptly addressed.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between carcinoma in situ and invasive carcinoma
  • Need for precise documentation of histological findings
  • Variability in treatment protocols based on patient demographics
  • Potential for co-existing conditions affecting coding

Audit Risk Factors

  • Inadequate documentation of biopsy results
  • Failure to document follow-up care and surveillance
  • Misclassification of the stage of cancer
  • Inconsistent coding of related procedures

Specialty Focus

Medical Specialties

Gastroenterology

Documentation Requirements

Detailed pathology reports, treatment plans, and follow-up notes.

Common Clinical Scenarios

Patients presenting with rectal bleeding, abnormal findings on colonoscopy, or routine surveillance for high-risk patients.

Billing Considerations

Ensure accurate staging and documentation of any co-existing gastrointestinal conditions.

Oncology

Documentation Requirements

Comprehensive treatment history, including surgical notes and pathology findings.

Common Clinical Scenarios

Management of patients post-excision of rectal carcinoma in situ and monitoring for recurrence.

Billing Considerations

Coordination with pathology for accurate coding of histological findings.

Coding Guidelines

Inclusion Criteria

Use D01.2 When
  • According to the ICD
  • CM coding guidelines, carcinoma in situ is classified under neoplasms and requires specific documentation of the site and histological type

Exclusion Criteria

Do NOT use D01.2 When
  • Exclusion criteria include any invasive carcinoma or lesions that do not meet the criteria for carcinoma in situ

Related ICD-10 Codes

Related CPT Codes

45385CPT Code

Endoscopic excision of rectal lesion

Clinical Scenario

Used when a biopsy confirms carcinoma in situ and excision is performed.

Documentation Requirements

Pathology report confirming carcinoma in situ and operative notes detailing the procedure.

Specialty Considerations

Gastroenterologists must ensure accurate coding based on findings during the procedure.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of carcinoma in situ, improving the accuracy of cancer registries and treatment planning. It has also emphasized the importance of detailed documentation in clinical practice.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of carcinoma in situ, improving the accuracy of cancer registries and treatment planning. It has also emphasized the importance of detailed documentation in clinical practice.

Reimbursement & Billing Impact

reimbursement.

Resources

Clinical References

  • •
    American Cancer Society - Carcinoma in Situ

Coding & Billing References

  • •
    American Cancer Society - Carcinoma in Situ

Frequently Asked Questions

What is the prognosis for carcinoma in situ of the rectum?

The prognosis for carcinoma in situ of the rectum is generally favorable, especially with early detection and appropriate management. Regular surveillance is crucial to monitor for any progression to invasive cancer.