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ICD-10 Guide
ICD-10 CodesD03.111

D03.111

Billable

Melanoma in situ of right upper eyelid, including canthus

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

Code Description

ICD-10 D03.111 is a billable code used to indicate a diagnosis of melanoma in situ of right upper eyelid, including canthus.

Key Diagnostic Point:

Melanoma in situ of the right upper eyelid, including the canthus, is a localized form of skin cancer characterized by the presence of atypical melanocytes confined to the epidermis. This condition is considered a precursor to invasive melanoma and is typically asymptomatic in its early stages. The right upper eyelid, being a delicate area, requires careful monitoring and management due to its proximity to the eye and the potential for cosmetic and functional impairment. Diagnosis is often made through a biopsy, which reveals the presence of atypical melanocytes. Treatment usually involves surgical excision to ensure complete removal of the cancerous cells. Surveillance protocols are critical, as patients with melanoma in situ are at an increased risk for developing invasive melanoma in the future. Regular follow-ups, including skin examinations and patient education on self-monitoring for changes in skin lesions, are essential components of care. The prognosis for melanoma in situ is generally favorable when detected early and treated appropriately, but ongoing vigilance is necessary to prevent progression.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Specificity of the anatomical location (right upper eyelid, including canthus)
  • Need for precise documentation of the diagnosis and treatment plan
  • Potential for misclassification with other skin lesions
  • Variability in treatment approaches based on patient factors

Audit Risk Factors

  • Inadequate documentation of the biopsy results
  • Failure to document follow-up care and surveillance
  • Misclassification of the lesion as invasive melanoma
  • Lack of clarity in treatment plans

Specialty Focus

Medical Specialties

Dermatology

Documentation Requirements

Detailed clinical notes including biopsy results, treatment plans, and follow-up care.

Common Clinical Scenarios

Diagnosis and management of melanoma in situ, patient education on skin self-examination.

Billing Considerations

Ensure accurate documentation of the lesion's characteristics and treatment outcomes.

Ophthalmology

Documentation Requirements

Documentation of any ocular involvement and coordination with dermatology for treatment.

Common Clinical Scenarios

Management of eyelid lesions, assessment of functional impairment due to lesions.

Billing Considerations

Consideration of cosmetic outcomes and functional preservation in treatment planning.

Coding Guidelines

Inclusion Criteria

Use D03.111 When
  • According to the official coding guidelines, D03
  • 111 should be used when the melanoma is confirmed as in situ and specifically located on the right upper eyelid
  • Coders must ensure that the documentation supports the diagnosis and that any treatment provided is accurately reflected in the medical record

Exclusion Criteria

Do NOT use D03.111 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

11600CPT Code

Excision, malignant skin lesion, face, ears, scalp, neck; excised diameter over 4.0 cm

Clinical Scenario

Used when excising melanoma in situ from the right upper eyelid.

Documentation Requirements

Document the size of the lesion, excised margins, and pathology results.

Specialty Considerations

Ensure coordination between dermatology and ophthalmology for eyelid lesions.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for greater specificity in coding melanoma in situ, enabling better tracking of treatment outcomes and patient demographics. This specificity aids in research and improves the quality of care provided.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding melanoma in situ, enabling better tracking of treatment outcomes and patient demographics. This specificity aids in research and improves the quality of care provided.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for greater specificity in coding melanoma in situ, enabling better tracking of treatment outcomes and patient demographics. This specificity aids in research and improves the quality of care provided.

Resources

Clinical References

  • •
    American Academy of Dermatology

Coding & Billing References

  • •
    American Academy of Dermatology

Frequently Asked Questions

What is the significance of coding melanoma in situ?

Coding melanoma in situ accurately is crucial for tracking the incidence of skin cancer, guiding treatment decisions, and ensuring appropriate follow-up care to prevent progression to invasive melanoma.