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ICD-10 Guide
ICD-10 CodesD05.10

D05.10

Billable

Intraductal carcinoma in situ of unspecified breast

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

Code Description

ICD-10 D05.10 is a billable code used to indicate a diagnosis of intraductal carcinoma in situ of unspecified breast.

Key Diagnostic Point:

Intraductal carcinoma in situ (DCIS) of the breast is a non-invasive form of breast cancer characterized by the presence of abnormal cells within the ducts of the breast tissue. These cells have not invaded surrounding breast tissue, which differentiates DCIS from invasive breast cancer. The condition is often detected through mammography, where microcalcifications may be noted. DCIS is considered a precursor to invasive breast cancer, and while it is not life-threatening in itself, it poses a significant risk for progression to invasive disease if left untreated. Treatment options typically include lumpectomy, mastectomy, and radiation therapy, depending on the extent of the disease and patient preferences. Surveillance protocols for patients diagnosed with DCIS often involve regular mammograms and clinical breast exams to monitor for any signs of progression. The risk of progression to invasive breast cancer varies based on factors such as the grade of the DCIS, the presence of comedonecrosis, and the patient's age and family history. Understanding these factors is crucial for determining the appropriate management and follow-up care.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in documentation of DCIS grades and types
  • Need for precise coding based on pathology reports
  • Differentiation from invasive breast cancer codes
  • Potential for multiple treatment modalities impacting coding

Audit Risk Factors

  • Inadequate documentation of pathology results
  • Failure to specify laterality when applicable
  • Misclassification of DCIS as invasive cancer
  • Inconsistent follow-up documentation

Specialty Focus

Medical Specialties

Oncology

Documentation Requirements

Detailed pathology reports, treatment plans, and follow-up care notes.

Common Clinical Scenarios

Diagnosis of DCIS following a mammogram, treatment planning for lumpectomy or mastectomy.

Billing Considerations

Ensure accurate staging and grading of DCIS to guide treatment and follow-up.

Radiology

Documentation Requirements

Clear imaging reports indicating findings of microcalcifications or other abnormalities.

Common Clinical Scenarios

Mammography findings leading to biopsy and diagnosis of DCIS.

Billing Considerations

Documentation must correlate imaging findings with pathology results.

Coding Guidelines

Inclusion Criteria

Use D05.10 When
  • According to ICD
  • CM guidelines, D05
  • 10 should be used when the specific laterality of the breast is not documented
  • Coders must ensure that the diagnosis is confirmed by pathology and that the condition is not classified as invasive

Exclusion Criteria

Do NOT use D05.10 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

19301CPT Code

Mastectomy, partial (lumpectomy)

Clinical Scenario

Used when a patient with DCIS undergoes a lumpectomy.

Documentation Requirements

Operative report detailing the procedure and findings.

Specialty Considerations

Oncology specialists must ensure accurate coding based on the surgical approach.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of breast conditions, including DCIS, which aids in better tracking of treatment outcomes and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of breast conditions, including DCIS, which aids in better tracking of treatment outcomes and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of breast conditions, including DCIS, which aids in better tracking of treatment outcomes and resource allocation.

Resources

Clinical References

  • •
    American Cancer Society - Breast Cancer

Coding & Billing References

  • •
    American Cancer Society - Breast Cancer

Frequently Asked Questions

What is the difference between DCIS and invasive breast cancer?

DCIS is a non-invasive condition where abnormal cells are confined to the ducts of the breast, while invasive breast cancer has spread beyond the ducts into surrounding tissue.