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ICD-10 Guide
ICD-10 CodesD04.62

D04.62

Billable

Carcinoma in situ of skin of left upper limb, including shoulder

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

Code Description

ICD-10 D04.62 is a billable code used to indicate a diagnosis of carcinoma in situ of skin of left upper limb, including shoulder.

Key Diagnostic Point:

Carcinoma in situ (CIS) of the skin represents a localized, non-invasive form of skin cancer where abnormal cells are present but have not invaded deeper tissues. In the case of D04.62, this condition specifically affects the skin of the left upper limb, including the shoulder. CIS is often detected through skin examinations and biopsies, and it is characterized by the presence of atypical keratinocytes confined to the epidermis. Risk factors for developing CIS include prolonged sun exposure, fair skin, and a history of skin cancer. Surveillance protocols typically involve regular dermatological evaluations to monitor for changes in the lesion's appearance or behavior. Although CIS is not life-threatening, there is a risk of progression to invasive carcinoma if left untreated, necessitating timely intervention. 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

  • Specificity of the anatomical location (left upper limb, including shoulder)
  • Differentiation from other skin conditions and cancers
  • Need for precise documentation of biopsy results
  • Potential for progression to invasive carcinoma requiring follow-up coding

Audit Risk Factors

  • Inadequate documentation of biopsy results
  • Failure to document follow-up care or surveillance
  • Misclassification of the lesion as invasive rather than in situ
  • Inconsistent coding of treatment modalities

Specialty Focus

Medical Specialties

Dermatology

Documentation Requirements

Detailed descriptions of the lesion, biopsy results, and treatment plans.

Common Clinical Scenarios

Patients presenting with suspicious skin lesions requiring biopsy and follow-up.

Billing Considerations

Ensure accurate documentation of lesion characteristics and patient history to support coding.

Oncology

Documentation Requirements

Comprehensive treatment plans and follow-up care documentation.

Common Clinical Scenarios

Management of patients with a history of skin cancer or those undergoing surveillance for CIS.

Billing Considerations

Documenting the risk of progression to invasive carcinoma is crucial for accurate coding.

Coding Guidelines

Inclusion Criteria

Use D04.62 When
  • According to ICD
  • 10 coding guidelines, D04
  • 62 should be used when the diagnosis is confirmed through biopsy and the lesion is localized to the specified area

Exclusion Criteria

Do NOT use D04.62 When
  • Exclusion criteria include lesions that have progressed to invasive carcinoma or those that are not confirmed through histological examination

Related ICD-10 Codes

Related CPT Codes

11100CPT Code

Biopsy of skin, excisional

Clinical Scenario

Used when a biopsy is performed to confirm CIS.

Documentation Requirements

Document the site, size, and method of biopsy.

Specialty Considerations

Dermatologists should ensure clear documentation of the lesion's characteristics.

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 carcinoma in situ, improving the accuracy of patient records and treatment plans. D04.62 provides a clear indication of the lesion's location and status, which is crucial for treatment and surveillance.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like carcinoma in situ, improving the accuracy of patient records and treatment plans. D04.62 provides a clear indication of the lesion's location and status, which is crucial for treatment and surveillance.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of conditions like carcinoma in situ, improving the accuracy of patient records and treatment plans. D04.62 provides a clear indication of the lesion's location and status, which is crucial for treatment and surveillance.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

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 are essential to prevent progression to invasive cancer.