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ICD-10 Guide
ICD-10 CodesD04.5

D04.5

Billable

Carcinoma in situ of skin of trunk

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

Code Description

ICD-10 D04.5 is a billable code used to indicate a diagnosis of carcinoma in situ of skin of trunk.

Key Diagnostic Point:

Carcinoma in situ (CIS) of the skin of the trunk refers to a localized form of skin cancer where abnormal cells are present but have not invaded deeper tissues or metastasized. This condition is characterized by atypical keratinocytes confined to the epidermis, which can arise from various skin types and is often associated with sun exposure, fair skin, and a history of skin lesions. The trunk includes the torso, encompassing the chest and abdomen, and is a common site for such lesions. Early detection and treatment are crucial, as untreated CIS can progress to invasive squamous cell carcinoma (SCC). Surveillance protocols typically involve regular skin examinations, patient education on sun protection, and monitoring for changes in existing lesions. The risk of progression to invasive cancer varies based on factors such as lesion size, histological subtype, and patient demographics. Effective management often includes surgical excision, topical chemotherapy, or photodynamic therapy, depending on the lesion's characteristics and patient preferences.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between carcinoma in situ and invasive carcinoma
  • Understanding the specific location and type of carcinoma
  • Documentation of patient history and risk factors
  • Knowledge of treatment options and their implications for coding

Audit Risk Factors

  • Inadequate documentation of lesion characteristics
  • Failure to document patient history of skin cancer
  • Lack of follow-up notes on surveillance and treatment
  • Misclassification of invasive vs. non-invasive lesions

Specialty Focus

Medical Specialties

Dermatology

Documentation Requirements

Detailed descriptions of lesions, treatment plans, and follow-up care.

Common Clinical Scenarios

Diagnosis and treatment of skin lesions, routine skin checks, and management of high-risk patients.

Billing Considerations

Ensure accurate documentation of lesion size, location, and histological findings.

Oncology

Documentation Requirements

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

Common Clinical Scenarios

Management of skin cancers, including follow-up after excision and monitoring for recurrence.

Billing Considerations

Documenting the rationale for treatment choices and patient education on skin cancer risks.

Coding Guidelines

Inclusion Criteria

Use D04.5 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's characteristics and any relevant patient history

Exclusion Criteria

Do NOT use D04.5 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

11400CPT Code

Excision, malignant skin lesion, face, ears, scalp, neck

Clinical Scenario

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

Documentation Requirements

Document the size of the lesion and the margins of excision.

Specialty Considerations

Dermatologists should ensure clear documentation of the lesion's characteristics.

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 for skin cancer management.

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 for skin cancer management.

Reimbursement & Billing Impact

reimbursement processes for skin cancer management.

Resources

Clinical References

  • •
    American Academy of Dermatology

Coding & Billing References

  • •
    American Academy of Dermatology

Frequently Asked Questions

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

Carcinoma in situ refers to cancer cells that have not invaded surrounding tissues, while invasive carcinoma has spread beyond the original site. Accurate coding requires clear documentation of the lesion's characteristics.