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ICD-10 Guide
ICD-10 CodesD01.5

D01.5

Billable

Carcinoma in situ of liver, gallbladder and bile ducts

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

Code Description

ICD-10 D01.5 is a billable code used to indicate a diagnosis of carcinoma in situ of liver, gallbladder and bile ducts.

Key Diagnostic Point:

Carcinoma in situ (CIS) of the liver, gallbladder, and bile ducts represents a localized neoplastic condition where malignant cells are present but have not invaded surrounding tissues. This condition is characterized by the presence of atypical cells confined to the epithelial layer of the liver, gallbladder, or bile ducts, without evidence of metastasis or invasion into adjacent structures. The diagnosis is typically made through imaging studies, such as ultrasound, CT, or MRI, and confirmed via biopsy. Patients with CIS may be asymptomatic or present with nonspecific symptoms such as abdominal pain or jaundice. Surveillance protocols often include regular imaging and liver function tests to monitor for progression to invasive carcinoma. The risk of progression to invasive cancer varies based on factors such as the underlying liver disease, presence of cirrhosis, and the specific characteristics of the carcinoma in situ. Early detection and management are crucial to prevent progression and improve patient outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between carcinoma in situ and invasive carcinoma
  • Need for precise documentation of biopsy results
  • Variability in clinical presentation and symptoms
  • Potential overlap with other liver conditions

Audit Risk Factors

  • Inadequate documentation of biopsy results
  • Failure to document surveillance protocols
  • Misclassification of invasive versus non-invasive disease
  • Lack of follow-up documentation

Specialty Focus

Medical Specialties

Hepatology

Documentation Requirements

Detailed documentation of liver function tests, imaging studies, and biopsy results.

Common Clinical Scenarios

Patients presenting with abnormal liver function tests and imaging findings suggestive of CIS.

Billing Considerations

Consideration of underlying liver disease such as hepatitis or cirrhosis is crucial for accurate coding.

Oncology

Documentation Requirements

Comprehensive cancer staging and treatment plans must be documented.

Common Clinical Scenarios

Patients undergoing treatment for CIS, including surgical intervention or surveillance.

Billing Considerations

Coordination with pathology reports is essential to confirm the diagnosis of carcinoma in situ.

Coding Guidelines

Inclusion Criteria

Use D01.5 When
  • According to ICD
  • CM guidelines, D01
  • 5 should be used when carcinoma in situ is confirmed through biopsy
  • It is important to document the specific site and any relevant clinical findings

Exclusion Criteria

Do NOT use D01.5 When
  • Exclusion criteria include cases where the carcinoma has progressed to invasive disease

Related ICD-10 Codes

Related CPT Codes

88305CPT Code

Pathology examination, surgical

Clinical Scenario

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

Documentation Requirements

Pathology report must clearly indicate carcinoma in situ.

Specialty Considerations

Pathologists must provide detailed findings to support the diagnosis.

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 granularity of data collection and enhancing the ability to track outcomes and treatment efficacy.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of carcinoma in situ, improving the granularity of data collection and enhancing the ability to track outcomes and treatment efficacy.

Reimbursement & Billing Impact

reimbursement and compliance with regulatory standards.

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 stage in cancer development, indicating that malignant cells are present but have not invaded surrounding tissues. Early detection and management are essential to prevent progression to invasive cancer.