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ICD-10 Guide
ICD-10 CodesD01.3

D01.3

Billable

Carcinoma in situ of anus and anal canal

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

Code Description

ICD-10 D01.3 is a billable code used to indicate a diagnosis of carcinoma in situ of anus and anal canal.

Key Diagnostic Point:

Carcinoma in situ of the anus and anal canal refers to a localized form of cancer where abnormal cells are present in the epithelial layer of the anal canal or anus but have not invaded deeper tissues. This condition is often asymptomatic in its early stages and may be discovered during routine examinations or screenings. Risk factors include human papillomavirus (HPV) infection, immunosuppression, and a history of anal warts. Surveillance protocols typically involve regular anal Pap smears and high-resolution anoscopy to monitor for progression to invasive cancer. The prognosis for carcinoma in situ is generally favorable, but there is a risk of progression to invasive carcinoma, particularly in high-risk populations. Early detection and intervention are crucial for effective management and improved outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between carcinoma in situ and invasive carcinoma
  • Understanding the implications of HPV-related conditions
  • Navigating surveillance protocols and follow-up care
  • Documenting the absence of symptoms or signs of progression

Audit Risk Factors

  • Inadequate documentation of surveillance and follow-up care
  • Misclassification of carcinoma in situ as invasive cancer
  • Failure to document risk factors or comorbidities
  • Inconsistent coding of related procedures

Specialty Focus

Medical Specialties

Oncology

Documentation Requirements

Detailed pathology reports, treatment plans, and follow-up notes.

Common Clinical Scenarios

Diagnosis of carcinoma in situ during routine screening, management of HPV-related lesions.

Billing Considerations

Ensure accurate staging and documentation of any treatments or interventions.

Gastroenterology

Documentation Requirements

Endoscopy reports, biopsy results, and patient history.

Common Clinical Scenarios

Surveillance colonoscopy findings, management of anal dysplasia.

Billing Considerations

Document any findings related to anal canal lesions and follow-up recommendations.

Coding Guidelines

Inclusion Criteria

Use D01.3 When
  • According to ICD
  • 10 guidelines, D01
  • 3 should be used when carcinoma in situ is confirmed by biopsy
  • It is important to document the specific site and any associated risk factors

Exclusion Criteria

Do NOT use D01.3 When
  • Exclusion criteria include cases where the carcinoma has progressed to invasive disease

Related ICD-10 Codes

Related CPT Codes

45385CPT Code

Endoscopic biopsy of anal canal

Clinical Scenario

Used when a biopsy is performed to confirm carcinoma in situ.

Documentation Requirements

Pathology report confirming diagnosis and procedure notes.

Specialty Considerations

Oncologists and gastroenterologists should ensure clear documentation of 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 ability to track and manage this condition. It emphasizes the importance of accurate documentation and coding practices to reflect the severity and management of the disease.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of carcinoma in situ, improving the ability to track and manage this condition. It emphasizes the importance of accurate documentation and coding practices to reflect the severity and management of the disease.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of carcinoma in situ, improving the ability to track and manage this condition. It emphasizes the importance of accurate documentation and coding practices to reflect the severity and management of the disease.

Resources

Clinical References

  • •
    American Cancer Society - Anal Cancer

Coding & Billing References

  • •
    American Cancer Society - Anal Cancer

Frequently Asked Questions

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

Carcinoma in situ is a critical early stage of cancer that, if left untreated, can progress to invasive cancer. Early detection and management are essential for favorable outcomes.