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ICD-10 Guide
ICD-10 CodesD05.02

D05.02

Billable

Lobular carcinoma in situ of left breast

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

Code Description

ICD-10 D05.02 is a billable code used to indicate a diagnosis of lobular carcinoma in situ of left breast.

Key Diagnostic Point:

Lobular carcinoma in situ (LCIS) of the left breast is a non-invasive form of breast cancer characterized by the abnormal proliferation of lobular cells within the breast lobules. Unlike invasive breast cancer, LCIS does not invade surrounding breast tissue but is considered a marker for an increased risk of developing invasive breast cancer in either breast later in life. Patients with LCIS typically do not present with a palpable mass or symptoms, and diagnosis is often made incidentally during breast biopsies performed for other reasons. Surveillance protocols for patients diagnosed with LCIS include regular clinical breast examinations and annual mammograms, with some guidelines recommending MRI for high-risk patients. The risk of progression to invasive breast cancer is estimated to be about 20-30% over the next 30 years, necessitating careful monitoring and potential preventive measures, such as chemoprevention or prophylactic mastectomy, depending on individual risk factors and patient preferences.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiation from other types of breast carcinoma in situ
  • Need for precise documentation of laterality
  • Understanding of surveillance protocols and risk assessment
  • Potential for co-existing conditions or diagnoses

Audit Risk Factors

  • Inadequate documentation of diagnosis and treatment plan
  • Failure to document patient discussions regarding surveillance
  • Misclassification of LCIS as invasive carcinoma
  • Inconsistent coding of laterality

Specialty Focus

Medical Specialties

Oncology

Documentation Requirements

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

Common Clinical Scenarios

Diagnosis of LCIS during routine screening, management of patients with a family history of breast cancer.

Billing Considerations

Documentation should clearly outline the rationale for surveillance strategies and any preventive measures discussed with the patient.

Radiology

Documentation Requirements

Clear imaging reports indicating findings and recommendations for follow-up imaging.

Common Clinical Scenarios

Mammography or MRI findings leading to biopsy for suspected LCIS.

Billing Considerations

Radiology reports should specify the findings that led to the diagnosis and any recommendations for further imaging.

Coding Guidelines

Inclusion Criteria

Use D05.02 When
  • According to ICD
  • 10 coding guidelines, LCIS is classified under neoplasms of uncertain behavior
  • Coders should ensure accurate documentation of the diagnosis, laterality, and any associated risk factors

Exclusion Criteria

Do NOT use D05.02 When
  • Exclusion criteria include invasive lobular carcinoma and other breast neoplasms

Related ICD-10 Codes

Related CPT Codes

19120CPT Code

Excision, breast, tumor, open, excisional biopsy

Clinical Scenario

Used when a biopsy is performed to confirm the diagnosis of LCIS.

Documentation Requirements

Pathology report confirming LCIS and operative notes detailing the procedure.

Specialty Considerations

Oncologists should ensure that the diagnosis is clearly documented in the operative report.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of lobular carcinoma in situ, improving the accuracy of data collection and enhancing the ability to track patient outcomes and treatment efficacy.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of lobular carcinoma in situ, improving the accuracy of data collection and enhancing the ability to track patient outcomes and treatment efficacy.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of lobular carcinoma in situ, improving the accuracy of data collection and enhancing the ability to track patient outcomes and treatment efficacy.

Resources

Clinical References

  • •
    American Cancer Society - Lobular Carcinoma In Situ

Coding & Billing References

  • •
    American Cancer Society - Lobular Carcinoma In Situ

Frequently Asked Questions

What is lobular carcinoma in situ?

Lobular carcinoma in situ (LCIS) is a non-invasive breast condition where abnormal cells are found in the lobules of the breast. It is not considered breast cancer but indicates an increased risk for developing invasive breast cancer in the future.

How is LCIS diagnosed?

LCIS is typically diagnosed through a breast biopsy, often performed after abnormal findings on a mammogram. It is usually asymptomatic and may be found incidentally.

What are the treatment options for LCIS?

Management of LCIS primarily involves regular surveillance with clinical exams and imaging. Some patients may consider preventive measures such as chemoprevention or prophylactic surgery, depending on their individual risk factors.