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ICD-10 Guide
ICD-10 CodesD07.5

D07.5

Billable

Carcinoma in situ of prostate

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

Code Description

ICD-10 D07.5 is a billable code used to indicate a diagnosis of carcinoma in situ of prostate.

Key Diagnostic Point:

Carcinoma in situ of the prostate refers to a localized, non-invasive form of prostate cancer where malignant cells are present in the prostate gland but have not invaded surrounding tissues. This condition is often asymptomatic and is typically discovered incidentally during routine screenings, such as prostate-specific antigen (PSA) tests or biopsies. The diagnosis of carcinoma in situ is significant as it indicates a potential risk for progression to invasive cancer. Surveillance protocols often involve regular monitoring through PSA levels, digital rectal exams (DRE), and repeat biopsies to assess any changes in the condition. The risk of progression to invasive cancer varies based on several factors, including the patient's age, family history, and the characteristics of the carcinoma in situ itself. Early detection and management are crucial to prevent the development of more advanced disease, making understanding this diagnosis essential for healthcare providers and coders alike.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between carcinoma in situ and invasive carcinoma
  • Understanding the nuances of surveillance protocols
  • Interpreting pathology reports accurately
  • Keeping up with evolving guidelines and recommendations

Audit Risk Factors

  • Inadequate documentation of surveillance protocols
  • Failure to document patient consent for monitoring
  • Misclassification of carcinoma in situ as invasive cancer
  • Lack of follow-up documentation

Specialty Focus

Medical Specialties

Urology

Documentation Requirements

Detailed pathology reports, PSA levels, and follow-up plans.

Common Clinical Scenarios

Routine screening, biopsy results indicating carcinoma in situ, and management discussions.

Billing Considerations

Ensure accurate staging and grading of the carcinoma in situ.

Oncology

Documentation Requirements

Comprehensive treatment plans, patient history, and risk assessment.

Common Clinical Scenarios

Consultations for treatment options and monitoring strategies.

Billing Considerations

Documenting multidisciplinary approaches to patient management.

Coding Guidelines

Inclusion Criteria

Use D07.5 When
  • According to ICD
  • 10 guidelines, D07
  • 5 should be used when carcinoma in situ is confirmed through biopsy
  • It is essential to document the absence of invasive disease and to follow the coding conventions for neoplasms

Exclusion Criteria

Do NOT use D07.5 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

55700CPT Code

Prostate biopsy, needle, core, or incisional

Clinical Scenario

Used when a biopsy is performed to confirm carcinoma in situ.

Documentation Requirements

Pathology report confirming diagnosis and indication for biopsy.

Specialty Considerations

Urologists must document the rationale for biopsy and follow-up plans.

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 data accuracy and facilitating better tracking of patient outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of carcinoma in situ, improving data accuracy and facilitating better tracking of patient outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of carcinoma in situ, improving data accuracy and facilitating better tracking of patient outcomes.

Resources

Clinical References

  • •
    American Urological Association Guidelines

Coding & Billing References

  • •
    American Urological Association Guidelines

Frequently Asked Questions

What is the significance of diagnosing carcinoma in situ of the prostate?

Diagnosing carcinoma in situ is crucial as it indicates a localized cancer that has not yet invaded surrounding tissues, allowing for early intervention and monitoring to prevent progression to invasive cancer.