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v1.0.0
ICD-10 Guide
ICD-10 CodesD04.122

D04.122

Billable

Carcinoma in situ of skin of left lower eyelid, including canthus

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

Code Description

ICD-10 D04.122 is a billable code used to indicate a diagnosis of carcinoma in situ of skin of left lower eyelid, including canthus.

Key Diagnostic Point:

Carcinoma in situ (CIS) of the skin is a non-invasive form of cancer characterized by the presence of abnormal cells that have not yet invaded deeper tissues. In the case of D04.122, this condition specifically affects the skin of the left lower eyelid, including the canthus, which is the corner of the eye where the upper and lower eyelids meet. CIS is often detected through skin examinations and may present as a persistent lesion, ulcer, or change in skin color. The risk factors for developing CIS include prolonged sun exposure, fair skin, and a history of skin cancer. Surveillance protocols typically involve regular dermatological examinations to monitor for changes in the lesion and to assess for potential progression to invasive carcinoma. The progression risk for CIS is variable, with some lesions remaining stable while others may progress to invasive cancer if left untreated. Early detection and treatment are crucial to prevent such progression, making awareness and regular follow-up essential for patients diagnosed with this condition.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Specificity of the anatomical location (left lower eyelid, including canthus)
  • Differentiation from other skin lesions
  • Need for precise documentation of the lesion's characteristics
  • Potential for progression to invasive carcinoma

Audit Risk Factors

  • Inadequate documentation of lesion characteristics
  • Failure to document surveillance follow-up
  • Misclassification of the lesion type
  • Inconsistent coding of related procedures

Specialty Focus

Medical Specialties

Dermatology

Documentation Requirements

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

Common Clinical Scenarios

Diagnosis of CIS during routine skin checks, treatment planning for excision or monitoring.

Billing Considerations

Ensure that all findings are documented clearly to support the diagnosis and treatment plan.

Ophthalmology

Documentation Requirements

Documentation of ocular health, potential impact on vision, and any surgical interventions.

Common Clinical Scenarios

Management of eyelid lesions, coordination with dermatology for treatment.

Billing Considerations

Consideration of the cosmetic and functional implications of treatment on the eyelid.

Coding Guidelines

Inclusion Criteria

Use D04.122 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the diagnosis and any related procedures
  • Include details about the lesion's characteristics and treatment plan

Exclusion Criteria

Do NOT use D04.122 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

11600CPT Code

Excision, malignant skin lesion

Clinical Scenario

Used when excising a CIS lesion on the left lower eyelid.

Documentation Requirements

Document the size of the lesion and the technique used for excision.

Specialty Considerations

Ensure coordination between dermatology and ophthalmology for eyelid lesions.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of conditions like D04.122, improving the accuracy of data collection and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like D04.122, improving the accuracy of data collection and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

Resources

Clinical References

  • •
    American Academy of Dermatology

Coding & Billing References

  • •
    American Academy of Dermatology

Frequently Asked Questions

What is carcinoma in situ?

Carcinoma in situ is a non-invasive cancer where abnormal cells are present but have not spread to surrounding tissues. It is often treatable and has a good prognosis when detected early.