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ICD-10 Guide
ICD-10 CodesD02.4

D02.4

Billable

Carcinoma in situ of respiratory system, unspecified

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

Code Description

ICD-10 D02.4 is a billable code used to indicate a diagnosis of carcinoma in situ of respiratory system, unspecified.

Key Diagnostic Point:

Carcinoma in situ (CIS) of the respiratory system refers to a localized form of cancer that has not invaded surrounding tissues. This condition is characterized by abnormal cells that are confined to the epithelial layer of the respiratory tract, which includes the trachea, bronchi, and lungs. The term 'unspecified' indicates that the exact site of the carcinoma in situ within the respiratory system is not clearly defined. CIS is considered a precancerous condition, and while it is not invasive, it has the potential to progress to invasive cancer if left untreated. Surveillance protocols typically involve regular monitoring through imaging studies and bronchoscopy, depending on the patient's risk factors and clinical presentation. The risk of progression to invasive carcinoma varies based on factors such as the patient's age, smoking history, and the presence of other comorbidities. Early detection and intervention are crucial in managing this condition to prevent progression to more advanced stages of cancer.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Unspecified site may lead to ambiguity in documentation.
  • Requires thorough understanding of respiratory anatomy for accurate coding.
  • Differentiation from other types of lung cancers can be challenging.
  • Need for precise documentation of surveillance and follow-up protocols.

Audit Risk Factors

  • Inadequate documentation of the site of carcinoma.
  • Failure to document surveillance and follow-up care.
  • Misinterpretation of biopsy results.
  • Inconsistent coding practices among different providers.

Specialty Focus

Medical Specialties

Oncology

Documentation Requirements

Detailed pathology reports and imaging studies must be documented to support the diagnosis.

Common Clinical Scenarios

Patients with abnormal findings on imaging or biopsy results indicating carcinoma in situ.

Billing Considerations

Oncologists must ensure that the diagnosis is clearly documented to avoid confusion with invasive cancers.

Pulmonology

Documentation Requirements

Pulmonary function tests and imaging studies should be included in the patient's record.

Common Clinical Scenarios

Patients presenting with respiratory symptoms and abnormal imaging findings.

Billing Considerations

Pulmonologists should document the patient's smoking history and other risk factors.

Coding Guidelines

Inclusion Criteria

Use D02.4 When
  • According to ICD
  • 10 coding guidelines, carcinoma in situ is classified under neoplasms
  • Coders must ensure that the diagnosis is supported by pathology reports and that the site is specified when possible

Exclusion Criteria

Do NOT use D02.4 When
  • Exclusion criteria include invasive cancers and benign neoplasms

Related ICD-10 Codes

Related CPT Codes

31625CPT Code

Bronchoscopy, rigid or flexible

Clinical Scenario

Used for biopsy of suspected carcinoma in situ lesions.

Documentation Requirements

Document indication for bronchoscopy and findings.

Specialty Considerations

Pulmonologists should ensure that the procedure is linked to the diagnosis of carcinoma in situ.

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 enhancing the ability to track patient 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 cancer registries and enhancing the ability to track patient outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of carcinoma in situ, improving the accuracy of cancer registries and enhancing the ability to track patient 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 carcinoma in situ?

Carcinoma in situ is a localized form of cancer where abnormal cells are present but have not invaded surrounding tissues. It is considered a precancerous condition.

How is carcinoma in situ monitored?

Monitoring typically involves regular imaging studies and follow-up visits to assess for any changes in the condition.