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ICD-10 Guide
ICD-10 CodesD04.7

D04.7

Billable

Carcinoma in situ of skin of lower limb, including hip

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

Code Description

ICD-10 D04.7 is a billable code used to indicate a diagnosis of carcinoma in situ of skin of lower limb, including hip.

Key Diagnostic Point:

Carcinoma in situ (CIS) of the skin is a non-invasive form of skin cancer characterized by the presence of abnormal cells that have not yet invaded deeper tissues. Specifically, D04.7 refers to CIS located on the lower limb, including the hip. This condition is often identified through skin examinations and biopsies, where atypical keratinocytes are found confined to the epidermis. Risk factors for developing CIS include prolonged sun exposure, fair skin, and a history of skin lesions. Patients may present with various skin changes, including scaly patches, non-healing sores, or changes in existing moles. Early detection and treatment are crucial to prevent progression to invasive carcinoma. Treatment options typically include surgical excision, cryotherapy, or topical chemotherapy. Regular surveillance is essential for patients diagnosed with CIS, as there is a risk of progression to invasive cancer if left untreated. The prognosis is generally favorable with appropriate management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiation from other skin lesions
  • Need for precise documentation of location
  • Potential for progression to invasive carcinoma
  • Variability in treatment protocols

Audit Risk Factors

  • Inadequate documentation of biopsy results
  • Failure to document treatment plans
  • Misclassification of invasive vs. non-invasive lesions
  • Lack of follow-up documentation

Specialty Focus

Medical Specialties

Dermatology

Documentation Requirements

Detailed descriptions of lesions, biopsy results, and treatment plans.

Common Clinical Scenarios

Diagnosis and management of skin lesions, follow-up for CIS, and treatment of skin cancers.

Billing Considerations

Ensure accurate documentation of lesion characteristics and treatment response.

Oncology

Documentation Requirements

Comprehensive treatment history, including surgical and non-surgical interventions.

Common Clinical Scenarios

Management of skin cancer patients, including surveillance and treatment of CIS.

Billing Considerations

Focus on the risk of progression and the need for ongoing monitoring.

Coding Guidelines

Inclusion Criteria

Use D04.7 When
  • According to ICD
  • 10 guidelines, D04
  • 7 should be used when documenting carcinoma in situ specifically located on the lower limb and hip
  • It is important to ensure that the diagnosis is confirmed through appropriate clinical evaluation and biopsy results

Exclusion Criteria

Do NOT use D04.7 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

11400CPT Code

Excision, benign skin lesion

Clinical Scenario

Used when excising a CIS lesion from the lower limb.

Documentation Requirements

Document the size, location, and pathology results of the excised lesion.

Specialty Considerations

Dermatologists should ensure accurate coding based on the excised 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 skin conditions, improving the accuracy of data collection and reimbursement processes for conditions like D04.7.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of skin conditions, improving the accuracy of data collection and reimbursement processes for conditions like D04.7.

Reimbursement & Billing Impact

reimbursement processes for conditions like D04.7.

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 early stage of cancer where abnormal cells are present but have not invaded surrounding tissues. Early detection and treatment are essential to prevent progression to invasive cancer.