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ICD-10 Guide
ICD-10 CodesD01.40

D01.40

Billable

Carcinoma in situ of unspecified part of intestine

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

Code Description

ICD-10 D01.40 is a billable code used to indicate a diagnosis of carcinoma in situ of unspecified part 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 'unspecified part of intestine' indicates that the precise location within the intestinal tract—whether it be the small intestine, large intestine, or rectum—is not clearly defined. CIS is considered an early stage of cancer, and while it is not life-threatening at this stage, it has the potential to progress to invasive cancer if left untreated. Surveillance protocols typically involve regular monitoring through colonoscopy or imaging studies to detect any changes in the cellular structure or the emergence of invasive cancer. The risk of progression varies based on factors such as the histological type of the carcinoma, patient age, and underlying health conditions. Early detection and intervention are crucial for improving patient outcomes and preventing the transition to invasive disease.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Unspecified location complicates documentation and coding.
  • Requires understanding of carcinoma in situ versus invasive cancer.
  • Potential for misclassification with other intestinal conditions.
  • Need for precise documentation of surveillance protocols.

Audit Risk Factors

  • Inadequate documentation of the carcinoma's location.
  • Failure to document surveillance and follow-up care.
  • Misinterpretation of biopsy results.
  • Inconsistent coding practices across providers.

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 screenings, management of patients with a history of intestinal polyps.

Billing Considerations

Ensure clear documentation of the carcinoma's characteristics and any treatment interventions.

Gastroenterology

Documentation Requirements

Endoscopy reports, biopsy results, and surveillance protocols.

Common Clinical Scenarios

Routine colonoscopy revealing carcinoma in situ, monitoring patients post-polypectomy.

Billing Considerations

Accurate coding of the procedure and findings is essential for proper billing.

Coding Guidelines

Inclusion Criteria

Use D01.40 When
  • According to ICD
  • 10 coding guidelines, carcinoma in situ codes should be used when there is definitive diagnosis from pathology
  • The code D01
  • 40 should be applied when the specific site of the carcinoma is not documented
  • It is important to ensure that the diagnosis is confirmed through appropriate clinical and pathological evaluation

Exclusion Criteria

Do NOT use D01.40 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

45378CPT Code

Colonoscopy, flexible, diagnostic

Clinical Scenario

Used during routine screenings or follow-ups for patients with carcinoma in situ.

Documentation Requirements

Endoscopy report detailing findings and any biopsies taken.

Specialty Considerations

Gastroenterologists should ensure accurate coding 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 accuracy of data collection and enhancing the ability to track patient outcomes. D01.40 provides a clear designation for cases where the specific site is not documented, which aids in research and epidemiological studies.

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 enhancing the ability to track patient outcomes. D01.40 provides a clear designation for cases where the specific site is not documented, which aids in research and epidemiological studies.

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 enhancing the ability to track patient outcomes. D01.40 provides a clear designation for cases where the specific site is not documented, which aids in research and epidemiological studies.

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 an early form of cancer that has not spread beyond its original site. It is crucial for early detection and intervention to prevent progression to invasive cancer.