ICD-10 Logo
ICDxICD-10 Medical Coding
ICD-10 Logo
ICDxICD-10 Medical Coding
ICD 10 CodesDiagnoses
ICD 10 CodesDiagnoses
ICD-10 Logo
ICDxICD-10 Medical Coding

Comprehensive ICD-10-CM code reference with AI-powered search capabilities.

© 2025 ICD Code Compass. All rights reserved.

Browse

  • All Chapters
  • All Categories
  • Diagnoses

Tools

  • AI Code Search
ICD-10-CM codes are maintained by the CDC and CMS. This tool is for reference purposes only.
v1.0.0
ICD-10 Guide
ICD-10 CodesD04.0

D04.0

Billable

Carcinoma in situ of skin of lip

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

Code Description

ICD-10 D04.0 is a billable code used to indicate a diagnosis of carcinoma in situ of skin of lip.

Key Diagnostic Point:

Carcinoma in situ of the skin of the lip refers to a localized, non-invasive form of cancer that is confined to the epithelial layer of the lip. This condition is characterized by the abnormal proliferation of keratinocytes, which can lead to the development of squamous cell carcinoma if left untreated. Clinically, it may present as a persistent sore, ulcer, or lesion on the lip that does not heal. Risk factors include excessive sun exposure, tobacco use, and a history of actinic keratosis. Diagnosis is typically confirmed through a biopsy, which reveals atypical keratinocytes confined to the epidermis. Treatment options may include surgical excision, cryotherapy, or topical chemotherapy. Regular surveillance is crucial, as carcinoma in situ can progress to invasive cancer if not monitored and managed appropriately. Patients are advised to undergo periodic skin examinations and to practice sun protection to mitigate further risk.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between carcinoma in situ and invasive carcinoma
  • Need for precise documentation of biopsy results
  • Variability in clinical presentation
  • Potential for co-existing skin conditions

Audit Risk Factors

  • Inadequate documentation of biopsy results
  • Failure to document follow-up care
  • Misclassification of the lesion type
  • Lack of patient history regarding risk factors

Specialty Focus

Medical Specialties

Dermatology

Documentation Requirements

Detailed descriptions of lesions, biopsy results, and treatment plans.

Common Clinical Scenarios

Diagnosis and management of suspicious lip lesions, follow-up after treatment.

Billing Considerations

Ensure accurate documentation of lesion characteristics and treatment response.

Oncology

Documentation Requirements

Comprehensive treatment history, including surgical and non-surgical interventions.

Common Clinical Scenarios

Management of patients with a history of skin cancers, surveillance protocols.

Billing Considerations

Documenting the patient's risk factors and treatment outcomes is crucial for coding.

Coding Guidelines

Inclusion Criteria

Use D04.0 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the diagnosis, treatment, and follow
  • up care
  • Include specific details about the lesion and any associated conditions

Exclusion Criteria

Do NOT use D04.0 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

11600CPT Code

Excision, malignant skin lesion, face, ears, scalp, neck; excised diameter excised 0.5 cm or less

Clinical Scenario

Used when excising a carcinoma in situ lesion on the lip.

Documentation Requirements

Document the size of the lesion and the excised diameter.

Specialty Considerations

Ensure the procedure is documented in the context of the diagnosis.

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 treatment tracking.

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 treatment tracking.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of carcinoma in situ, improving the accuracy of data collection and treatment tracking.

Resources

Clinical References

  • •
    American Academy of Dermatology

Coding & Billing References

  • •
    American Academy of Dermatology

Frequently Asked Questions

What is the significance of carcinoma in situ of the lip?

Carcinoma in situ of the lip is a pre-cancerous condition that requires monitoring and potential treatment to prevent progression to invasive cancer.