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ICD-10 Guide
ICD-10 CodesD04.11

D04.11

Billable

Carcinoma in situ of skin of right eyelid, including canthus

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

Code Description

ICD-10 D04.11 is a billable code used to indicate a diagnosis of carcinoma in situ of skin of right eyelid, including canthus.

Key Diagnostic Point:

Carcinoma in situ of the skin of the right eyelid, including the canthus, is a localized form of skin cancer characterized by the presence of abnormal cells that have not invaded deeper tissues. This condition is often associated with sun exposure and can manifest as a scaly patch, a raised bump, or a sore that does not heal. The eyelid is a particularly sensitive area, and lesions here can affect vision and cosmetic appearance. Diagnosis typically involves a biopsy, which confirms the presence of atypical keratinocytes confined to the epidermis. Treatment options may include surgical excision, cryotherapy, or topical chemotherapy, depending on the size and characteristics of the lesion. Regular follow-up is essential to monitor for recurrence or the development of new lesions, as patients with carcinoma in situ are at increased risk for subsequent skin cancers.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Specificity of the anatomical location (right 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 lesion characteristics

Audit Risk Factors

  • Inadequate documentation of the biopsy results
  • Failure to document the treatment plan and follow-up
  • Misclassification of the lesion type or location
  • Lack of evidence for surveillance protocols

Specialty Focus

Medical Specialties

Dermatology

Documentation Requirements

Detailed clinical notes including lesion size, location, and treatment plan.

Common Clinical Scenarios

Diagnosis and treatment of skin lesions, follow-up for skin cancer surveillance.

Billing Considerations

Ensure accurate documentation of the biopsy results and treatment modalities.

Ophthalmology

Documentation Requirements

Documentation of any impact on vision and coordination with dermatology for treatment.

Common Clinical Scenarios

Management of eyelid lesions affecting vision or requiring surgical intervention.

Billing Considerations

Consideration of cosmetic outcomes and functional implications of eyelid surgery.

Coding Guidelines

Inclusion Criteria

Use D04.11 When
  • Follow official ICD
  • 10 coding guidelines, ensuring accurate documentation of the diagnosis, treatment, and follow
  • up care
  • Include specific details about the lesion's characteristics and location

Exclusion Criteria

Do NOT use D04.11 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

11400CPT Code

Excision, benign lesion

Clinical Scenario

Used when excising a carcinoma in situ lesion from the eyelid.

Documentation Requirements

Document the size and location of the lesion, along with the excision details.

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 more specific coding of conditions like carcinoma in situ, improving the accuracy of data collection and reimbursement processes.

ICD-9 vs ICD-10

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

Reimbursement & Billing Impact

reimbursement processes.

Resources

Clinical References

  • •
    American Academy of Dermatology

Coding & Billing References

  • •
    American Academy of Dermatology

Frequently Asked Questions

What is the significance of coding D04.11 accurately?

Accurate coding of D04.11 is crucial for appropriate treatment planning, reimbursement, and tracking of skin cancer incidence. It ensures that patients receive the necessary follow-up care and surveillance for potential progression.