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ICD-10 Guide
ICD-10 CodesD01.7

D01.7

Billable

Carcinoma in situ of other specified digestive organs

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

Code Description

ICD-10 D01.7 is a billable code used to indicate a diagnosis of carcinoma in situ of other specified digestive organs.

Key Diagnostic Point:

Carcinoma in situ (CIS) of other specified digestive organs refers to a localized cancerous condition where abnormal cells are present in the lining of the digestive tract but have not invaded deeper tissues or metastasized to other parts of the body. This condition can occur in various parts of the digestive system, including the esophagus, stomach, intestines, and rectum. The diagnosis of carcinoma in situ is significant as it indicates a pre-invasive stage of cancer, which, if left untreated, has the potential to progress to invasive cancer. Surveillance protocols typically involve regular endoscopic examinations and biopsies to monitor for any changes in the cellular structure. The risk of progression to invasive carcinoma varies depending on the specific organ involved, the histological characteristics of the carcinoma, and the patient's overall health. Early detection and intervention are crucial in managing this condition effectively, as timely treatment can significantly improve patient outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in documentation across specialties
  • Need for precise anatomical localization
  • Differentiation from other neoplastic conditions
  • Potential for misclassification with invasive cancers

Audit Risk Factors

  • Inadequate documentation of pathology findings
  • Failure to specify the exact organ involved
  • Misuse of codes for invasive cancers
  • Inconsistent follow-up documentation

Specialty Focus

Medical Specialties

Gastroenterology

Documentation Requirements

Detailed endoscopic findings, biopsy results, and treatment plans.

Common Clinical Scenarios

Patients undergoing surveillance for dysplasia or early-stage cancer.

Billing Considerations

Ensure clear documentation of the location and characteristics of the carcinoma in situ.

Oncology

Documentation Requirements

Comprehensive treatment history, pathology reports, and follow-up care plans.

Common Clinical Scenarios

Management of patients with a diagnosis of carcinoma in situ and planning for potential surgical intervention.

Billing Considerations

Document the rationale for treatment decisions and any multidisciplinary discussions.

Coding Guidelines

Inclusion Criteria

Use D01.7 When
  • According to ICD
  • 10 coding guidelines, D01
  • 7 should be used when the carcinoma in situ is confirmed by pathology and is not classified as invasive
  • It is important to document the specific digestive organ involved and any relevant clinical findings

Exclusion Criteria

Do NOT use D01.7 When
  • Exclusion criteria include any documented invasion of surrounding tissues

Related ICD-10 Codes

Related CPT Codes

45378CPT Code

Colonoscopy, flexible, diagnostic

Clinical Scenario

Used for surveillance of carcinoma in situ in the colon.

Documentation Requirements

Document findings, including any biopsies taken.

Specialty Considerations

Gastroenterologists should ensure clear 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 ability to track and manage these conditions. D01.7 provides a clear distinction from invasive cancers, which is crucial for treatment planning and surveillance.

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 these conditions. D01.7 provides a clear distinction from invasive cancers, which is crucial for treatment planning and surveillance.

Reimbursement & Billing Impact

reimbursement.

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, significantly improving patient outcomes.