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v1.0.0
ICD-10 Guide
ICD-10 CodesD09.1

D09.1

Billable

Carcinoma in situ of other and unspecified urinary organs

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

Code Description

ICD-10 D09.1 is a billable code used to indicate a diagnosis of carcinoma in situ of other and unspecified urinary organs.

Key Diagnostic Point:

Carcinoma in situ (CIS) of the urinary organs refers to a localized cancer that has not invaded surrounding tissues. This condition can occur in various parts of the urinary system, including the bladder, ureters, and kidneys, but when classified under D09.1, it indicates that the specific site is either unspecified or falls outside the more commonly defined categories. CIS is characterized by abnormal cells that have the potential to become invasive cancer if left untreated. Surveillance protocols for patients diagnosed with CIS typically involve regular cystoscopic examinations and urine cytology to monitor for progression to invasive disease. The risk of progression varies based on factors such as the histological grade of the tumor, the presence of associated lesions, and patient demographics. Early detection and intervention are crucial in managing this condition effectively, as timely treatment can significantly reduce the risk of progression to invasive cancer.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in documentation of the specific urinary organ involved
  • Differentiation from other urinary tract neoplasms
  • Need for precise staging and grading information
  • Potential for overlapping symptoms with benign conditions

Audit Risk Factors

  • Inadequate documentation of the diagnosis
  • Failure to specify the urinary organ involved
  • Inconsistent follow-up documentation
  • Misclassification of the condition as invasive cancer

Specialty Focus

Medical Specialties

Urology

Documentation Requirements

Detailed pathology reports, imaging studies, and treatment plans must be documented.

Common Clinical Scenarios

Diagnosis of CIS during routine screening, follow-up after treatment, and management of recurrence.

Billing Considerations

Ensure clarity on the specific urinary organ involved and the histological characteristics of the carcinoma.

Oncology

Documentation Requirements

Comprehensive treatment history, including chemotherapy or radiation therapy details.

Common Clinical Scenarios

Management of patients undergoing surveillance after CIS diagnosis and treatment planning.

Billing Considerations

Document the rationale for surveillance protocols and any changes in patient status.

Coding Guidelines

Inclusion Criteria

Use D09.1 When
  • According to ICD
  • 10 coding guidelines, D09
  • 1 should be used when the carcinoma is confirmed as in situ and the specific urinary organ is not documented
  • Coders should ensure that the diagnosis is supported by pathology reports and that the condition is not classified as invasive

Exclusion Criteria

Do NOT use D09.1 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

52000CPT Code

Cystoscopy

Clinical Scenario

Used for diagnosis and surveillance of CIS.

Documentation Requirements

Cystoscopy reports must detail findings and any interventions.

Specialty Considerations

Urologists should document the reason for cystoscopy and any abnormalities noted.

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 reimbursement processes. D09.1 provides a clear classification for cases that do not fit into more specific categories, aiding in research and treatment planning.

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 reimbursement processes. D09.1 provides a clear classification for cases that do not fit into more specific categories, aiding in research and treatment planning.

Reimbursement & Billing Impact

reimbursement processes. D09.1 provides a clear classification for cases that do not fit into more specific categories, aiding in research and treatment planning.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What is the significance of carcinoma in situ?

Carcinoma in situ is significant because it represents an early stage of cancer that has not yet invaded surrounding tissues. Early detection and treatment can prevent progression to invasive cancer.