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ICD-10 Guide
ICD-10 CodesChapter 2: NeoplasmsD01

D01

Billable

Carcinoma in situ of other and unspecified digestive organs

Chapter 2:Neoplasms

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

Code Description

ICD-10 D01 is a billable code used to indicate a diagnosis of carcinoma in situ of other and unspecified digestive organs.

Key Diagnostic Point:

Carcinoma in situ (CIS) of the digestive organs refers to a localized cancer that has not invaded surrounding tissues. This condition is characterized by abnormal cells that are confined to the epithelial layer of the digestive tract, including the esophagus, stomach, intestines, and other unspecified digestive organs. The diagnosis of carcinoma in situ is critical as it indicates a pre-invasive stage of cancer, which, if left untreated, may progress to invasive cancer. Surveillance protocols typically involve regular endoscopic examinations, imaging studies, and biopsies to monitor for any signs of progression. The risk of progression varies depending on factors such as the specific organ involved, the histological type of carcinoma, and the patient's overall health. Early detection and intervention are essential to prevent the transition from carcinoma in situ to invasive cancer, making accurate coding and documentation vital for effective patient management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in documentation of carcinoma in situ across different specialties
  • Need for precise identification of the digestive organ involved
  • Differentiation from other neoplastic conditions
  • Potential for progression to invasive cancer requiring careful monitoring

Audit Risk Factors

  • Inadequate documentation of the specific site of carcinoma in situ
  • Failure to document surveillance protocols and follow-up care
  • Misclassification of carcinoma in situ as invasive cancer
  • Lack of clarity in pathology reports regarding histological type

Specialty Focus

Medical Specialties

Gastroenterology

Documentation Requirements

Detailed endoscopic findings, biopsy results, and follow-up plans.

Common Clinical Scenarios

Patients undergoing surveillance for dysplasia or early-stage cancer.

Billing Considerations

Ensure accurate documentation of the specific digestive organ and histological type.

Oncology

Documentation Requirements

Comprehensive treatment plans, staging information, and follow-up care.

Common Clinical Scenarios

Patients receiving treatment for carcinoma in situ and monitoring for progression.

Billing Considerations

Document the rationale for treatment decisions and any changes in patient status.

Coding Guidelines

Inclusion Criteria

Use D01 When
  • According to ICD
  • 10 coding guidelines, carcinoma in situ codes should be used when there is clear documentation of the diagnosis, and the condition is confirmed by pathology

Exclusion Criteria

Do NOT use D01 When
  • Exclusion criteria include any invasive cancer diagnosis or conditions that do not meet the criteria for carcinoma in situ

Related CPT Codes

45378CPT Code

Colonoscopy, flexible, diagnostic

Clinical Scenario

Used for surveillance of carcinoma in situ of the colon.

Documentation Requirements

Document findings, biopsy results, and follow-up plans.

Specialty Considerations

Gastroenterology specialists should ensure thorough documentation of the procedure and findings.

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 patient management. This specificity aids in tracking outcomes and guiding treatment protocols.

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 patient management. This specificity aids in tracking outcomes and guiding treatment protocols.

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 patient management. This specificity aids in tracking outcomes and guiding treatment protocols.

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 a critical diagnosis as it indicates a pre-invasive stage of cancer. Early detection and treatment can prevent progression to invasive cancer, making accurate coding and surveillance essential.