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ICD-10 Guide
ICD-10 CodesD07.4

D07.4

Billable

Carcinoma in situ of penis

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

Code Description

ICD-10 D07.4 is a billable code used to indicate a diagnosis of carcinoma in situ of penis.

Key Diagnostic Point:

Carcinoma in situ of the penis is a localized form of cancer characterized by the presence of abnormal cells that have not invaded surrounding tissues. This condition is often associated with risk factors such as human papillomavirus (HPV) infection, poor hygiene, and phimosis. Clinically, it may present as a lesion or ulcer on the glans or shaft of the penis, which can be asymptomatic or cause discomfort. Diagnosis typically involves a biopsy to confirm the presence of atypical squamous cells. Surveillance protocols for patients diagnosed with carcinoma in situ include regular follow-up examinations and monitoring for any signs of progression to invasive cancer. The risk of progression varies, but studies suggest that untreated carcinoma in situ can lead to invasive squamous cell carcinoma in a significant number of cases. Therefore, timely intervention and management are crucial to prevent disease advancement.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between carcinoma in situ and invasive carcinoma
  • Need for precise documentation of biopsy results
  • Variability in clinical presentation
  • Potential for co-existing conditions affecting coding

Audit Risk Factors

  • Inadequate documentation of biopsy results
  • Failure to document follow-up care and surveillance
  • Misclassification of the lesion as invasive
  • Lack of clarity in the clinical notes regarding the diagnosis

Specialty Focus

Medical Specialties

Urology

Documentation Requirements

Detailed clinical notes including biopsy results, treatment plans, and follow-up care.

Common Clinical Scenarios

Diagnosis and management of penile lesions, follow-up after biopsy, and treatment planning.

Billing Considerations

Urologists must ensure clear documentation of the lesion's characteristics and any associated symptoms.

Dermatology

Documentation Requirements

Comprehensive skin examination notes, including descriptions of lesions and biopsy findings.

Common Clinical Scenarios

Evaluation of skin lesions on the penis, management of HPV-related conditions.

Billing Considerations

Dermatologists should document the appearance and location of lesions thoroughly to support coding.

Coding Guidelines

Inclusion Criteria

Use D07.4 When
  • According to official coding guidelines, D07
  • 4 should be used when carcinoma in situ is confirmed through biopsy
  • It is essential to document the specific site and characteristics of the lesion

Exclusion Criteria

Do NOT use D07.4 When
  • Exclusion criteria include any invasive carcinoma or lesions that do not meet the criteria for carcinoma in situ

Related ICD-10 Codes

Related CPT Codes

11100CPT Code

Biopsy of skin, subcutaneous tissue, and/or mucous membrane

Clinical Scenario

Used when performing a biopsy to confirm carcinoma in situ.

Documentation Requirements

Document the site of biopsy, method used, and results.

Specialty Considerations

Urologists and dermatologists should ensure clear documentation of the biopsy process.

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 enhancing the ability to track disease progression and treatment 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 enhancing the ability to track disease progression and treatment 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 enhancing the ability to track disease progression and treatment outcomes.

Resources

Clinical References

  • •
    American Urological Association Guidelines

Coding & Billing References

  • •
    American Urological Association Guidelines

Frequently Asked Questions

What is the significance of carcinoma in situ of the penis?

Carcinoma in situ is a precursor to invasive cancer, and early detection and management are crucial to prevent progression.