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v1.0.0
ICD-10 Guide
ICD-10 CodesD03.61

D03.61

Billable

Melanoma in situ of right upper limb, including shoulder

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

Code Description

ICD-10 D03.61 is a billable code used to indicate a diagnosis of melanoma in situ of right upper limb, including shoulder.

Key Diagnostic Point:

Melanoma in situ is a type of skin cancer that is confined to the outer layer of skin (epidermis) and has not invaded deeper tissues. This specific code, D03.61, refers to melanoma in situ located on the right upper limb, which includes the shoulder area. Clinically, melanoma in situ is characterized by the presence of atypical melanocytes that are confined to the epidermis, without evidence of invasion into the dermis. It is crucial to identify and treat melanoma in situ early, as it has the potential to progress to invasive melanoma if left untreated. Surveillance protocols typically involve regular skin examinations and monitoring for changes in the lesion's appearance. The risk of progression to invasive melanoma varies based on factors such as lesion size, histological features, and patient demographics. Early detection and intervention are key to preventing progression and improving patient outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Specificity of the anatomical location (right upper limb, including shoulder)
  • Differentiation from other skin lesions and types of melanoma
  • Need for precise documentation of the lesion's characteristics
  • Potential for misclassification with invasive melanoma codes

Audit Risk Factors

  • Inadequate documentation of lesion characteristics
  • Failure to specify the exact location of the melanoma
  • Misuse of related codes for invasive melanoma
  • Lack of follow-up documentation post-treatment

Specialty Focus

Medical Specialties

Dermatology

Documentation Requirements

Detailed descriptions of the lesion, including size, color, and any changes over time.

Common Clinical Scenarios

Diagnosis and treatment of melanoma in situ, follow-up care, and surveillance.

Billing Considerations

Ensure accurate staging and documentation of any treatments performed.

Oncology

Documentation Requirements

Comprehensive treatment plans, including surgical interventions and follow-up care.

Common Clinical Scenarios

Management of melanoma in situ, including excision and monitoring for recurrence.

Billing Considerations

Coordination with dermatology for accurate staging and treatment documentation.

Coding Guidelines

Inclusion Criteria

Use D03.61 When
  • According to ICD
  • 10 coding guidelines, D03
  • 61 should be used when the melanoma is confirmed as in situ and located specifically on the right upper limb
  • Coders must ensure that the documentation supports the diagnosis and that the lesion has not progressed to invasive melanoma

Exclusion Criteria

Do NOT use D03.61 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

11600CPT Code

Excision, malignant skin lesion, face, ears, scalp, neck; excised diameter over 4.0 cm

Clinical Scenario

Used when excising a melanoma in situ from the right upper limb.

Documentation Requirements

Document the size of the lesion and the margins of excision.

Specialty Considerations

Dermatologists should ensure that the excision is documented in detail for accurate coding.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of melanoma in situ, improving the accuracy of data collection and treatment tracking. D03.61 provides a clear distinction from invasive melanoma codes, which aids in better patient management and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of melanoma in situ, improving the accuracy of data collection and treatment tracking. D03.61 provides a clear distinction from invasive melanoma codes, which aids in better patient management and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of melanoma in situ, improving the accuracy of data collection and treatment tracking. D03.61 provides a clear distinction from invasive melanoma codes, which aids in better patient management and resource allocation.

Resources

Clinical References

  • •
    American Academy of Dermatology

Coding & Billing References

  • •
    American Academy of Dermatology

Frequently Asked Questions

What is the difference between melanoma in situ and invasive melanoma?

Melanoma in situ is confined to the epidermis and has not invaded deeper tissues, while invasive melanoma has penetrated the dermis and may spread to other parts of the body.