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 CodesD05.11

D05.11

Billable

Intraductal carcinoma in situ of right breast

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

Code Description

ICD-10 D05.11 is a billable code used to indicate a diagnosis of intraductal carcinoma in situ of right breast.

Key Diagnostic Point:

Intraductal carcinoma in situ (DCIS) of the right breast is a non-invasive form of breast cancer characterized by the proliferation of malignant cells within the ducts of the breast tissue without invasion into the surrounding stroma. This condition is often detected through mammography, where microcalcifications may be noted. Patients may be asymptomatic, and the diagnosis is typically confirmed via biopsy. DCIS is classified as stage 0 breast cancer and is considered a precursor to invasive breast cancer. The risk of progression to invasive disease varies, with estimates suggesting that approximately 30-50% of untreated DCIS cases may progress to invasive breast cancer over a 10-year period. Treatment options often include surgical excision, radiation therapy, and hormonal therapy, depending on the tumor characteristics and patient preferences. Regular surveillance and follow-up are crucial for monitoring potential progression and managing treatment outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiation from other types of breast cancer
  • Need for precise documentation of laterality
  • Potential for overlapping diagnoses (e.g., lobular carcinoma in situ)
  • Variability in treatment protocols and follow-up care

Audit Risk Factors

  • Inadequate documentation of biopsy results
  • Failure to specify laterality
  • Misclassification with invasive breast cancer codes
  • Lack of follow-up documentation post-treatment

Specialty Focus

Medical Specialties

Oncology

Documentation Requirements

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

Common Clinical Scenarios

Diagnosis confirmation through biopsy, treatment planning, and monitoring for recurrence.

Billing Considerations

Ensure clarity in treatment intent (curative vs. palliative) and document any multidisciplinary discussions.

Radiology

Documentation Requirements

Clear imaging reports indicating findings suggestive of DCIS, including descriptions of calcifications.

Common Clinical Scenarios

Mammography findings leading to biopsy recommendations.

Billing Considerations

Accurate reporting of imaging findings is crucial for appropriate coding.

Coding Guidelines

Inclusion Criteria

Use D05.11 When
  • According to ICD
  • CM guidelines, D05
  • 11 should be used when the diagnosis of intraductal carcinoma in situ is confirmed and specifically pertains to the right breast
  • It is essential to document the laterality and ensure that the diagnosis is not confused with invasive breast cancer

Exclusion Criteria

Do NOT use D05.11 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

19301CPT Code

Mastectomy, partial (lumpectomy)

Clinical Scenario

Used when a patient with D05.11 undergoes a lumpectomy.

Documentation Requirements

Operative report detailing the procedure and findings.

Specialty Considerations

Oncology specialists should ensure comprehensive documentation of tumor characteristics.

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 D05.11, improving the granularity of data collection and enhancing the ability to track treatment outcomes and epidemiological trends.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like D05.11, improving the granularity of data collection and enhancing the ability to track treatment outcomes and epidemiological trends.

Reimbursement & Billing Impact

reimbursement and compliance with regulatory standards.

Resources

Clinical References

  • •
    American Cancer Society - Breast Cancer

Coding & Billing References

  • •
    American Cancer Society - Breast Cancer

Frequently Asked Questions

What is the significance of coding D05.11?

Coding D05.11 accurately reflects the diagnosis of intraductal carcinoma in situ, which is crucial for treatment planning, surveillance, and research purposes. It helps in tracking the incidence and outcomes of non-invasive breast cancer.