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ICD-10 Guide
ICD-10 CodesD04.30

D04.30

Billable

Carcinoma in situ of skin of unspecified part of face

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

Code Description

ICD-10 D04.30 is a billable code used to indicate a diagnosis of carcinoma in situ of skin of unspecified part of face.

Key Diagnostic Point:

Carcinoma in situ (CIS) of the skin represents a localized, non-invasive form of skin cancer that has not yet invaded surrounding tissues. Specifically, D04.30 refers to CIS occurring on an unspecified part of the face, which can include areas such as the cheeks, forehead, nose, or chin. This condition is characterized by the presence of atypical keratinocytes confined to the epidermis, with no evidence of invasion into the dermis. While CIS is not life-threatening, it is considered a precursor to invasive squamous cell carcinoma (SCC) and requires careful monitoring and management. Patients diagnosed with CIS may present with various clinical manifestations, including scaly patches, non-healing sores, or changes in existing moles. Surveillance protocols typically involve regular dermatological examinations to monitor for any signs of progression to invasive cancer. The risk of progression to invasive disease varies based on factors such as the size, location, and histological features of the carcinoma in situ. Early detection and treatment are crucial to prevent the development of more serious skin cancers.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Unspecified location may lead to ambiguity in documentation.
  • Differentiation from other skin lesions can be challenging.
  • Requires understanding of surveillance protocols and progression risks.
  • Potential for misclassification with other skin cancers.

Audit Risk Factors

  • Inadequate documentation of the diagnosis.
  • Failure to specify the site of the carcinoma.
  • Lack of follow-up documentation for surveillance.
  • Misalignment between clinical findings and coded diagnosis.

Specialty Focus

Medical Specialties

Dermatology

Documentation Requirements

Detailed clinical notes including lesion characteristics, biopsy results, and treatment plans.

Common Clinical Scenarios

Diagnosis of CIS during routine skin checks, management of lesions with cryotherapy or topical chemotherapy.

Billing Considerations

Ensure clear documentation of the site and characteristics of the carcinoma to avoid ambiguity.

Oncology

Documentation Requirements

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

Common Clinical Scenarios

Referral for surgical intervention or Mohs micrographic surgery for CIS lesions.

Billing Considerations

Documenting the rationale for treatment decisions and monitoring for progression.

Coding Guidelines

Inclusion Criteria

Use D04.30 When
  • According to ICD
  • 10 coding guidelines, D04
  • 30 should be used when the carcinoma in situ is confirmed by biopsy and the specific site on the face is not documented
  • Coders must ensure that the diagnosis is supported by clinical documentation and that the condition is not classified as invasive

Exclusion Criteria

Do NOT use D04.30 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

17311CPT Code

Destruction, malignant skin lesion

Clinical Scenario

Used when a CIS lesion is treated with cryotherapy.

Documentation Requirements

Document the size, location, and method of destruction.

Specialty Considerations

Dermatologists must ensure accurate coding based on the treatment provided.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of skin conditions, including carcinoma in situ. This specificity aids in better tracking of disease prevalence and treatment outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of skin conditions, including carcinoma in situ. This specificity aids in better tracking of disease prevalence and treatment outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of skin conditions, including carcinoma in situ. This specificity aids in better tracking of disease prevalence and treatment 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 non-invasive form of cancer that has the potential to progress to invasive cancer if not treated. Early detection and management are crucial to prevent this progression.