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ICD-10 Guide
ICD-10 CodesD01.4

D01.4

Billable

Carcinoma in situ of other and unspecified parts of intestine

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

Code Description

ICD-10 D01.4 is a billable code used to indicate a diagnosis of carcinoma in situ of other and unspecified parts of intestine.

Key Diagnostic Point:

Carcinoma in situ (CIS) of the intestine 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 intestinal lining. The term 'other and unspecified parts of intestine' indicates that the carcinoma is not specifically located in the colon, rectum, or small intestine, making it essential for coders to accurately identify the site of the lesion during documentation. Surveillance protocols for patients diagnosed with CIS typically involve regular endoscopic examinations and imaging studies to monitor for progression to invasive cancer. The risk of progression varies based on factors such as the histological type of the carcinoma, the patient's age, and the presence of dysplasia. Early detection and intervention are crucial, as the likelihood of progression to invasive cancer increases over time without appropriate management. Therefore, a multidisciplinary approach involving gastroenterologists, oncologists, and pathologists is often employed to ensure optimal patient outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in documentation of the specific site of carcinoma
  • Differentiation from other intestinal neoplasms
  • Need for precise histological reporting
  • Potential for overlapping symptoms with other gastrointestinal conditions

Audit Risk Factors

  • Inadequate documentation of the carcinoma site
  • Failure to document surveillance findings
  • Misinterpretation of pathology reports
  • Inconsistent coding practices among providers

Specialty Focus

Medical Specialties

Gastroenterology

Documentation Requirements

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

Common Clinical Scenarios

Patients undergoing surveillance colonoscopy for CIS, biopsy of suspicious lesions.

Billing Considerations

Ensure that all findings are clearly documented to support the diagnosis and coding.

Oncology

Documentation Requirements

Comprehensive treatment plans, histopathology reports, and patient follow-up.

Common Clinical Scenarios

Management of patients with CIS, including surgical intervention or chemoprevention.

Billing Considerations

Accurate staging and grading of the carcinoma are critical for coding and treatment decisions.

Coding Guidelines

Inclusion Criteria

Use D01.4 When
  • According to the ICD
  • CM coding guidelines, D01
  • 4 should be used when the carcinoma is confirmed as in situ and the specific site is not documented
  • Coders should ensure that the diagnosis is supported by pathology reports and clinical findings

Exclusion Criteria

Do NOT use D01.4 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

45378CPT Code

Colonoscopy, flexible, diagnostic

Clinical Scenario

Used for surveillance of patients with carcinoma in situ.

Documentation Requirements

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

Specialty Considerations

Gastroenterologists should ensure that all findings are clearly documented.

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. D01.4 provides a distinct code for cases that do not fit into more specific categories, enhancing the granularity of cancer registries.

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. D01.4 provides a distinct code for cases that do not fit into more specific categories, enhancing the granularity of cancer registries.

Reimbursement & Billing Impact

reimbursement. D01.4 provides a distinct code for cases that do not fit into more specific categories, enhancing the granularity of cancer registries.

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.