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ICD-10 Guide
ICD-10 CodesD05.8

D05.8

Billable

Other specified type of carcinoma in situ of breast

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

Code Description

ICD-10 D05.8 is a billable code used to indicate a diagnosis of other specified type of carcinoma in situ of breast.

Key Diagnostic Point:

Carcinoma in situ (CIS) of the breast refers to a group of abnormal cells that are found in the lining of the breast ducts or lobules. These cells have the potential to become invasive cancer but are not yet classified as malignant. The term 'other specified type' indicates that the carcinoma in situ does not fit into the more common categories such as ductal carcinoma in situ (DCIS) or lobular carcinoma in situ (LCIS). Surveillance protocols for patients diagnosed with D05.8 typically involve regular mammograms and clinical breast exams, as well as potential MRI imaging, depending on individual risk factors. The risk of progression to invasive breast cancer varies based on the specific type of carcinoma in situ, with some types having a higher likelihood of progression than others. Patients with carcinoma in situ are often monitored closely, and treatment options may include surgical excision, radiation therapy, or hormonal therapy, depending on the characteristics of the tumor and patient preferences.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in documentation of carcinoma types
  • Need for precise differentiation from other breast conditions
  • Potential for overlapping symptoms with invasive breast cancer
  • Variability in treatment protocols based on specific carcinoma type

Audit Risk Factors

  • Inadequate documentation of the specific type of carcinoma
  • Failure to document patient risk factors
  • Inconsistent coding of carcinoma in situ versus invasive cancer
  • Lack of follow-up documentation for surveillance protocols

Specialty Focus

Medical Specialties

Oncology

Documentation Requirements

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

Common Clinical Scenarios

Diagnosis of carcinoma in situ, treatment planning, and monitoring for progression.

Billing Considerations

Accurate coding requires understanding of the specific type of carcinoma and its treatment implications.

Radiology

Documentation Requirements

Imaging reports, findings from mammograms or MRIs, and recommendations for follow-up imaging.

Common Clinical Scenarios

Imaging for surveillance of patients with a history of carcinoma in situ.

Billing Considerations

Radiologists must ensure that imaging findings are clearly linked to the diagnosis of carcinoma in situ.

Coding Guidelines

Inclusion Criteria

Use D05.8 When
  • According to ICD
  • 10 coding guidelines, D05
  • 8 should be used when the specific type of carcinoma in situ is documented but does not fall under the more common categories
  • Coders must ensure that the documentation supports the diagnosis and that the condition is not classified as invasive cancer

Exclusion Criteria

Do NOT use D05.8 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

19301CPT Code

Mastectomy, partial (segmental resection)

Clinical Scenario

Used when a patient with D05.8 undergoes surgical intervention.

Documentation Requirements

Surgical notes detailing the procedure and findings.

Specialty Considerations

Oncologists must ensure that the diagnosis is clearly linked to the surgical procedure.

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 patient records and treatment plans. D05.8 provides a means to capture less common types of carcinoma in situ that may have unique management strategies.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of carcinoma in situ, improving the accuracy of patient records and treatment plans. D05.8 provides a means to capture less common types of carcinoma in situ that may have unique management strategies.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of carcinoma in situ, improving the accuracy of patient records and treatment plans. D05.8 provides a means to capture less common types of carcinoma in situ that may have unique management strategies.

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 D05.8?

Coding D05.8 is crucial for accurately representing the patient's diagnosis of carcinoma in situ that does not fit into the more common categories. It ensures appropriate surveillance and treatment protocols are followed.