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v1.0.0
ICD-10 Guide
ICD-10 CodesD05.82

D05.82

Billable

Other specified type of carcinoma in situ of left breast

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

Code Description

ICD-10 D05.82 is a billable code used to indicate a diagnosis of other specified type of carcinoma in situ of left breast.

Key Diagnostic Point:

Carcinoma in situ (CIS) of the breast refers to a non-invasive form of breast cancer where abnormal cells are found in the lining of the breast ducts or lobules but have not spread to surrounding tissues. The designation 'other specified type' indicates that the carcinoma does not fit into the more common categories such as ductal or lobular carcinoma in situ. This condition is significant as it represents a potential precursor to invasive breast cancer, necessitating careful monitoring and management. Patients diagnosed with D05.82 may undergo various surveillance protocols, including regular mammograms and clinical breast exams, to detect any progression to invasive disease. The risk of progression from carcinoma in situ to invasive breast cancer varies, with studies suggesting that approximately 30% of patients with untreated ductal carcinoma in situ may develop invasive cancer within 10 years. Therefore, timely intervention and adherence to surveillance protocols are crucial for patient outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in documentation of carcinoma types
  • Need for precise coding based on pathology reports
  • Differentiation from other breast conditions
  • Potential for misclassification with invasive cancers

Audit Risk Factors

  • Inadequate documentation of pathology results
  • Failure to specify the type of carcinoma in situ
  • Misalignment between diagnosis and treatment provided
  • Inconsistent follow-up documentation

Specialty Focus

Medical Specialties

Oncology

Documentation Requirements

Detailed pathology reports, treatment plans, and follow-up notes are essential for accurate coding.

Common Clinical Scenarios

Diagnosis of carcinoma in situ during routine screening, follow-up after initial diagnosis, and treatment planning.

Billing Considerations

Oncologists must ensure that all documentation reflects the specific type of carcinoma in situ to avoid coding errors.

Radiology

Documentation Requirements

Radiology reports must clearly indicate findings related to carcinoma in situ and any imaging studies performed.

Common Clinical Scenarios

Mammography findings suggestive of carcinoma in situ, imaging follow-up for surveillance.

Billing Considerations

Radiologists should provide comprehensive reports that correlate imaging findings with clinical diagnoses.

Coding Guidelines

Inclusion Criteria

Use D05.82 When
  • According to ICD
  • CM guidelines, D05
  • 82 should be used when the specific type of carcinoma in situ is documented and is not classified elsewhere
  • Coders must ensure that the diagnosis aligns with the clinical documentation and pathology findings

Exclusion Criteria

Do NOT use D05.82 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

19301CPT Code

Mastectomy, partial (lumpectomy)

Clinical Scenario

Used when a patient undergoes a lumpectomy for carcinoma in situ.

Documentation Requirements

Operative reports must detail the procedure and findings.

Specialty Considerations

Surgeons should ensure that the diagnosis of carcinoma in situ is clearly documented in operative notes.

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 treatment planning. D05.82 provides granularity that was not available in ICD-9, facilitating better patient management and research outcomes.

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 treatment planning. D05.82 provides granularity that was not available in ICD-9, facilitating better patient management and research outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of carcinoma in situ, improving the accuracy of data collection and treatment planning. D05.82 provides granularity that was not available in ICD-9, facilitating better patient management and research outcomes.

Resources

Clinical References

  • •
    American Cancer Society - Breast Cancer

Coding & Billing References

  • •
    American Cancer Society - Breast Cancer

Frequently Asked Questions

What is the significance of carcinoma in situ?

Carcinoma in situ is a non-invasive form of cancer that can progress to invasive cancer if left untreated. Early detection and management are crucial for preventing progression.