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v1.0.0
ICD-10 Guide
ICD-10 CodesD22.1

D22.1

Billable

Melanocytic nevi of eyelid, including canthus

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

Code Description

ICD-10 D22.1 is a billable code used to indicate a diagnosis of melanocytic nevi of eyelid, including canthus.

Key Diagnostic Point:

Melanocytic nevi, commonly referred to as moles, are benign tumors of melanocytes, the pigment-producing cells in the skin. When located on the eyelid or canthus, these nevi can vary in appearance, size, and color. They are typically asymptomatic and may be present at birth or develop over time. While most melanocytic nevi are benign, they can occasionally undergo changes that warrant further evaluation to rule out malignancy. The eyelid region is particularly sensitive due to its anatomical structure and function, making the management of nevi in this area crucial. Treatment options may include observation, surgical excision, or laser therapy, depending on the size, location, and any associated symptoms. Regular follow-up is essential to monitor for any changes in the nevi, as well as to ensure proper healing post-treatment. The presence of melanocytic nevi in this area may also necessitate a multidisciplinary approach involving dermatology and ophthalmology for optimal patient care.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Location specificity (eyelid and canthus)
  • Potential for cosmetic concerns
  • Need for differential diagnosis from malignant lesions
  • Variability in treatment options

Audit Risk Factors

  • Inadequate documentation of the size and characteristics of the nevi
  • Failure to document the rationale for treatment choice
  • Lack of follow-up notes on changes in the nevi
  • Misclassification of benign nevi as malignant

Specialty Focus

Medical Specialties

Dermatology

Documentation Requirements

Detailed descriptions of the nevi, including size, color, and any changes over time.

Common Clinical Scenarios

Evaluation of new or changing nevi, management of symptomatic nevi.

Billing Considerations

Ensure clear documentation of benign nature and any treatment performed.

Ophthalmology

Documentation Requirements

Assessment of visual function and any impact of nevi on eyelid movement.

Common Clinical Scenarios

Management of nevi affecting eyelid function or cosmetic appearance.

Billing Considerations

Collaboration with dermatology for comprehensive care.

Coding Guidelines

Inclusion Criteria

Use D22.1 When
  • According to ICD
  • 10 guidelines, D22
  • 1 should be used when documenting melanocytic nevi specifically located on the eyelid or canthus
  • It is important to differentiate these from other skin lesions and to document any associated symptoms or treatment

Exclusion Criteria

Do NOT use D22.1 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

11400CPT Code

Excision, benign lesion

Clinical Scenario

Used when a melanocytic nevus is excised for cosmetic reasons.

Documentation Requirements

Document size, location, and reason for excision.

Specialty Considerations

Dermatology may require additional notes on the cosmetic outcome.

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 melanocytic nevi, improving the accuracy of patient records and facilitating better management strategies.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like melanocytic nevi, improving the accuracy of patient records and facilitating better management strategies.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of conditions like melanocytic nevi, improving the accuracy of patient records and facilitating better management strategies.

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 difference between D22.1 and D22.0?

D22.1 specifically refers to melanocytic nevi located on the eyelid and canthus, while D22.0 refers to nevi located on the face. The distinction is important for accurate coding and treatment planning.