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ICD-10 Guide
ICD-10 CodesD01.49

D01.49

Billable

Carcinoma in situ of other parts of intestine

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

Code Description

ICD-10 D01.49 is a billable code used to indicate a diagnosis of carcinoma in situ of other parts of intestine.

Key Diagnostic Point:

Carcinoma in situ (CIS) of the intestine refers to a localized cancer that has not invaded surrounding tissues. This condition is characterized by the presence of abnormal cells in the lining of the intestine, which have the potential to develop into invasive cancer if left untreated. The term 'other parts of intestine' encompasses areas such as the jejunum, ileum, and other segments not specifically classified under more common sites like the colon or rectum. Diagnosis typically involves endoscopic procedures, biopsies, and imaging studies to assess the extent of the disease. Surveillance protocols for patients diagnosed with CIS include regular endoscopic evaluations and imaging to monitor for progression to invasive cancer. The risk of progression varies based on factors such as the histological grade of the carcinoma, the presence of dysplasia, and patient-specific factors like age and comorbidities. Early detection and intervention are crucial in managing this condition effectively, as timely treatment can prevent the development of invasive cancer.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiation from other intestinal neoplasms
  • Need for precise documentation of the site of carcinoma
  • Variability in histological findings
  • Potential for progression to invasive cancer requiring careful monitoring

Audit Risk Factors

  • Inadequate documentation of the diagnosis
  • Failure to specify the exact location of the carcinoma
  • Misclassification of the carcinoma type
  • Lack of follow-up documentation for surveillance

Specialty Focus

Medical Specialties

Gastroenterology

Documentation Requirements

Detailed endoscopic reports, biopsy results, and follow-up plans.

Common Clinical Scenarios

Patients undergoing surveillance for CIS after initial diagnosis, management of dysplastic lesions.

Billing Considerations

Ensure clear documentation of the site and histological findings to support coding.

Oncology

Documentation Requirements

Comprehensive treatment plans, pathology reports, and imaging studies.

Common Clinical Scenarios

Patients receiving treatment for CIS, monitoring for progression to invasive cancer.

Billing Considerations

Documenting the rationale for treatment decisions and follow-up care is critical.

Coding Guidelines

Inclusion Criteria

Use D01.49 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the diagnosis and site
  • Include any relevant clinical findings and treatment plans

Exclusion Criteria

Do NOT use D01.49 When
  • Exclude conditions that do not meet the criteria for carcinoma in situ

Related ICD-10 Codes

Related CPT Codes

45380CPT Code

Colonoscopy, flexible, diagnostic

Clinical Scenario

Used for surveillance in patients with carcinoma in situ.

Documentation Requirements

Document findings, biopsies taken, and any interventions performed.

Specialty Considerations

Gastroenterologists should ensure thorough documentation of the procedure and findings.

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 data collection and reimbursement processes. This specificity aids in better tracking of disease progression and treatment outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of carcinoma in situ, improving the accuracy of data collection and reimbursement processes. This specificity aids in better tracking of disease progression and treatment outcomes.

Reimbursement & Billing Impact

reimbursement processes. This specificity aids in better tracking of disease progression and treatment outcomes.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What is the difference between carcinoma in situ and invasive carcinoma?

Carcinoma in situ is a localized cancer that has not invaded surrounding tissues, while invasive carcinoma has spread beyond the epithelial layer into surrounding tissues.