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v1.0.0
ICD-10 Guide
ICD-10 CodesD09.19

D09.19

Billable

Carcinoma in situ of other urinary organs

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

Code Description

ICD-10 D09.19 is a billable code used to indicate a diagnosis of carcinoma in situ of other urinary organs.

Key Diagnostic Point:

Carcinoma in situ (CIS) of the urinary organs refers to a localized cancer that has not invaded surrounding tissues. This condition can occur in various parts of the urinary system, including the bladder, ureters, and urethra, but is not classified under the more common sites like the bladder. CIS is characterized by abnormal cells that are confined to the epithelial layer of the urinary organs, which means they have not spread to deeper tissues or other parts of the body. Early detection and treatment are crucial, as CIS can progress to invasive cancer if left untreated. Surveillance protocols typically involve regular cystoscopy and urine cytology to monitor for any changes in the cellular structure or the emergence of invasive disease. The risk of progression varies based on factors such as the specific organ involved, the presence of dysplasia, and patient demographics. Understanding the nuances of this diagnosis is essential for effective management and coding.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between carcinoma in situ and invasive carcinoma
  • Identifying the specific urinary organ affected
  • Understanding the implications of surveillance protocols
  • Navigating documentation requirements for various specialties

Audit Risk Factors

  • Inadequate documentation of the diagnosis
  • Failure to specify the urinary organ involved
  • Misclassification of carcinoma in situ as invasive cancer
  • Lack of follow-up documentation for surveillance

Specialty Focus

Medical Specialties

Urology

Documentation Requirements

Detailed pathology reports, imaging studies, and treatment plans.

Common Clinical Scenarios

Diagnosis of CIS during routine cystoscopy, management of bladder CIS.

Billing Considerations

Ensure clear documentation of the site and nature of the carcinoma.

Oncology

Documentation Requirements

Comprehensive treatment records, including chemotherapy or immunotherapy details.

Common Clinical Scenarios

Follow-up care for patients with a history of CIS, treatment planning.

Billing Considerations

Documenting the risk of progression and treatment response is critical.

Coding Guidelines

Inclusion Criteria

Use D09.19 When
  • According to the ICD
  • CM guidelines, D09
  • 19 should be used when the carcinoma is confirmed as in situ and the specific urinary organ is documented
  • It is important to follow the inclusion criteria for carcinoma in situ and ensure that the diagnosis is not confused with invasive cancer

Exclusion Criteria

Do NOT use D09.19 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

52224CPT Code

Cystoscopy with biopsy

Clinical Scenario

Used when a patient is diagnosed with CIS during cystoscopy.

Documentation Requirements

Pathology report confirming CIS and procedure notes.

Specialty Considerations

Urologists must document findings thoroughly to support coding.

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 the accuracy of data collection and treatment planning. D09.19 provides a clear distinction from invasive cancers, which is critical for patient management and research.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of carcinoma in situ, improving the accuracy of data collection and treatment planning. D09.19 provides a clear distinction from invasive cancers, which is critical for patient management and research.

Reimbursement & Billing Impact

reimbursement.

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 significant because it represents an early stage of cancer that has not yet invaded surrounding tissues. Early detection and treatment can prevent progression to invasive cancer.