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ICD-10 Guide
ICD-10 CodesD04.9

D04.9

Billable

Carcinoma in situ of skin, unspecified

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

Code Description

ICD-10 D04.9 is a billable code used to indicate a diagnosis of carcinoma in situ of skin, unspecified.

Key Diagnostic Point:

Carcinoma in situ of the skin is a non-invasive form of skin cancer characterized by the presence of abnormal cells that have not yet invaded deeper layers of the skin. This condition is often detected during routine skin examinations or biopsies. The term 'unspecified' indicates that the exact location or type of carcinoma in situ has not been clearly defined. Common types of carcinoma in situ include squamous cell carcinoma in situ (SCCIS) and basal cell carcinoma in situ (BCCIS). While these lesions are not life-threatening, they can progress to invasive cancer if left untreated. Regular surveillance and monitoring are crucial for early detection and intervention. Treatment options may include surgical excision, cryotherapy, or topical chemotherapy, depending on the lesion's characteristics and patient factors. The prognosis for carcinoma in situ is generally favorable, with a high cure rate when appropriately managed.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in documentation of lesion type and location
  • Need for precise clinical terminology to differentiate from invasive cancers
  • Potential for misclassification with other skin lesions
  • Variations in treatment protocols across specialties

Audit Risk Factors

  • Inadequate documentation of lesion characteristics
  • Failure to specify the site of the carcinoma in situ
  • Inconsistent follow-up notes regarding treatment outcomes
  • Misalignment between diagnosis and treatment codes

Specialty Focus

Medical Specialties

Dermatology

Documentation Requirements

Detailed descriptions of the lesion, including size, location, and histological findings.

Common Clinical Scenarios

Diagnosis during skin checks, biopsy results indicating carcinoma in situ, and treatment planning.

Billing Considerations

Ensure clear documentation of the type of carcinoma in situ and any treatment recommendations.

Oncology

Documentation Requirements

Comprehensive treatment plans, including follow-up care and surveillance protocols.

Common Clinical Scenarios

Management of patients with a history of skin cancer and surveillance for recurrence.

Billing Considerations

Document any multidisciplinary approaches to treatment and patient education efforts.

Coding Guidelines

Inclusion Criteria

Use D04.9 When
  • According to the ICD
  • CM coding guidelines, carcinoma in situ is classified under D04 codes
  • Coders must ensure that the diagnosis is supported by pathology reports and that the site of the carcinoma is documented

Exclusion Criteria

Do NOT use D04.9 When
  • Exclusions include invasive cancers and benign lesions

Related ICD-10 Codes

Related CPT Codes

11400CPT Code

Excision, benign lesion

Clinical Scenario

Used when excising a carcinoma in situ lesion.

Documentation Requirements

Pathology report confirming carcinoma in situ and details of the excised lesion.

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 data accuracy and facilitating better tracking of treatment outcomes and epidemiological studies.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of carcinoma in situ, improving data accuracy and facilitating better tracking of treatment outcomes and epidemiological studies.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of carcinoma in situ, improving data accuracy and facilitating better tracking of treatment outcomes and epidemiological studies.

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?

Carcinoma in situ is significant because it represents an early stage of cancer that has not invaded surrounding tissues. Early detection and treatment can prevent progression to invasive cancer.