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ICD-10 Guide
ICD-10 CodesD03.7

D03.7

Billable

Melanoma in situ of lower limb, including hip

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

Code Description

ICD-10 D03.7 is a billable code used to indicate a diagnosis of melanoma in situ of lower limb, including hip.

Key Diagnostic Point:

Melanoma in situ of the lower limb, including the hip, is a localized form of skin cancer characterized by the presence of atypical melanocytes confined to the epidermis. This condition is considered a precursor to invasive melanoma, where the malignant cells have not yet penetrated the dermis. Clinically, melanoma in situ may present as a pigmented lesion that can vary in color, shape, and size, often exhibiting irregular borders and asymmetry. Early detection is crucial as it significantly improves prognosis. Surveillance protocols typically involve regular skin examinations and monitoring for changes in the lesion's appearance. The risk of progression to invasive melanoma is a concern, particularly if the lesion is not adequately treated. Factors such as the size of the lesion, patient age, and history of sun exposure can influence the likelihood of progression. Treatment options often include surgical excision, which is the primary method for managing melanoma in situ, ensuring complete removal of the atypical cells to prevent further development.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between melanoma in situ and invasive melanoma
  • Variability in clinical presentation of lesions
  • Need for precise documentation of lesion characteristics
  • Potential for multiple lesions requiring individual coding

Audit Risk Factors

  • Inadequate documentation of lesion characteristics
  • Failure to document follow-up care and surveillance
  • Misclassification of lesion type or stage
  • Inconsistent coding of multiple lesions

Specialty Focus

Medical Specialties

Dermatology

Documentation Requirements

Detailed descriptions of lesion characteristics, size, location, and any changes over time.

Common Clinical Scenarios

Diagnosis and treatment of melanoma in situ, follow-up for surveillance, and management of multiple lesions.

Billing Considerations

Ensure accurate documentation of excision margins and pathology results.

Oncology

Documentation Requirements

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

Common Clinical Scenarios

Management of melanoma in situ, including discussions of progression risk and treatment options.

Billing Considerations

Coordination with dermatology for accurate staging and treatment documentation.

Coding Guidelines

Inclusion Criteria

Use D03.7 When
  • According to ICD
  • 10 coding guidelines, melanoma in situ is classified under D03 codes
  • It is essential to document the specific site of the melanoma accurately
  • Coders must ensure that the diagnosis aligns with the clinical documentation and that any treatment provided is appropriately linked to the diagnosis

Exclusion Criteria

Do NOT use D03.7 When
  • Exclusions include invasive melanoma and other skin cancers

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 lesion on the lower limb.

Documentation Requirements

Document the size of the lesion, excision margins, and pathology results.

Specialty Considerations

Dermatologists must ensure accurate coding based on the lesion's location and size.

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 enhancing patient care through better tracking of treatment outcomes.

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 enhancing patient care through better tracking of treatment outcomes.

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 enhancing patient care through better tracking of treatment outcomes.

Resources

Clinical References

  • •
    American Academy of Dermatology
  • •
    National Cancer Institute

Coding & Billing References

  • •
    American Academy of Dermatology
  • •
    National Cancer Institute

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 the dermis, while invasive melanoma has penetrated deeper layers of skin, which significantly affects treatment and prognosis.

How often should patients with melanoma in situ be monitored?

Patients should undergo regular skin examinations, typically every 3 to 6 months, to monitor for changes in existing lesions or the development of new lesions.