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ICD-10 Guide
ICD-10 CodesD04.2

D04.2

Billable

Carcinoma in situ of skin of ear and external auricular canal

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

Code Description

ICD-10 D04.2 is a billable code used to indicate a diagnosis of carcinoma in situ of skin of ear and external auricular canal.

Key Diagnostic Point:

Carcinoma in situ of the skin of the ear and external auricular canal refers to a localized form of skin cancer where abnormal cells are present but have not invaded deeper tissues. This condition is characterized by the presence of atypical keratinocytes confined to the epidermis, which can arise from sun exposure, genetic predisposition, or other environmental factors. The ear and external auricular canal are particularly susceptible to UV radiation, making them common sites for skin malignancies. Patients may present with lesions that appear as scaly patches, non-healing sores, or raised areas on the skin. Early detection and treatment are crucial to prevent progression to invasive carcinoma. Surveillance protocols typically involve regular dermatological examinations, patient education on sun protection, and monitoring for changes in the lesions. The risk of progression to invasive cancer is generally low but can increase with factors such as immunosuppression or a history of multiple skin cancers. Treatment options may include surgical excision, cryotherapy, or topical chemotherapy, depending on the lesion's characteristics and patient factors.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiation from other skin lesions
  • Need for precise documentation of lesion characteristics
  • Potential for multiple lesions requiring coding
  • Variability in treatment protocols

Audit Risk Factors

  • Inadequate documentation of lesion characteristics
  • Failure to document follow-up care
  • Misclassification of the lesion type
  • Inconsistent coding of multiple lesions

Specialty Focus

Medical Specialties

Dermatology

Documentation Requirements

Detailed descriptions of lesions, treatment plans, and follow-up notes.

Common Clinical Scenarios

Diagnosis and treatment of skin lesions, monitoring for progression.

Billing Considerations

Ensure accurate documentation of lesion size, location, and treatment response.

Oncology

Documentation Requirements

Comprehensive treatment history and follow-up care plans.

Common Clinical Scenarios

Management of patients with a history of skin cancers.

Billing Considerations

Document any systemic therapies or interventions that may affect coding.

Coding Guidelines

Inclusion Criteria

Use D04.2 When
  • According to the ICD
  • CM guidelines, D04
  • 2 should be used when the carcinoma in situ is confirmed by biopsy
  • It is important to document the specific site and characteristics of the lesion

Exclusion Criteria

Do NOT use D04.2 When
  • Exclusion criteria include lesions that are not confirmed as carcinoma in situ or those that have progressed to invasive cancer

Related ICD-10 Codes

Related CPT Codes

11400CPT Code

Excision, benign lesion

Clinical Scenario

Used when excising a carcinoma in situ lesion.

Documentation Requirements

Document the size, location, and type of lesion excised.

Specialty Considerations

Dermatologists should ensure that excision margins are documented.

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 accuracy of data collection and treatment tracking. This specificity aids in better patient management and research outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of carcinoma in situ, improving the accuracy of data collection and treatment tracking. This specificity aids in better patient management and research outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of carcinoma in situ, improving the accuracy of data collection and treatment tracking. This specificity aids in better patient management and research outcomes.

Resources

Clinical References

  • •
    American Academy of Dermatology

Coding & Billing References

  • •
    American Academy of Dermatology

Frequently Asked Questions

What is the significance of carcinoma in situ?

Carcinoma in situ is a critical diagnosis as it indicates the presence of abnormal cells that have not invaded surrounding tissues. Early detection and treatment can prevent progression to invasive cancer.