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ICD-10 Guide
ICD-10 CodesD09.20

D09.20

Billable

Carcinoma in situ of unspecified eye

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

Code Description

ICD-10 D09.20 is a billable code used to indicate a diagnosis of carcinoma in situ of unspecified eye.

Key Diagnostic Point:

Carcinoma in situ (CIS) of the eye refers to a localized cancerous condition where abnormal cells are found in the epithelial layer of the eye but have not invaded deeper tissues. This condition is often asymptomatic in its early stages and may be discovered incidentally during routine eye examinations or imaging studies. The term 'unspecified' indicates that the exact location within the eye (such as the conjunctiva, cornea, or retina) is not documented. Surveillance protocols for patients diagnosed with CIS typically involve regular ophthalmologic examinations, including visual acuity tests, slit-lamp examinations, and possibly imaging studies to monitor for any signs of progression to invasive cancer. The risk of progression to invasive carcinoma varies based on factors such as the type of carcinoma, patient age, and overall health. Early detection and intervention are crucial in managing this condition, as timely treatment can prevent the development of more serious ocular malignancies.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Unspecified location within the eye complicates documentation.
  • Differentiating between various types of ocular carcinomas.
  • Need for thorough clinical documentation to support diagnosis.
  • Potential for misclassification with other eye conditions.

Audit Risk Factors

  • Inadequate documentation of the diagnosis.
  • Failure to specify the location of the carcinoma.
  • Lack of follow-up documentation for surveillance.
  • Misalignment between clinical findings and coded diagnosis.

Specialty Focus

Medical Specialties

Ophthalmology

Documentation Requirements

Detailed clinical notes including examination findings, imaging results, and treatment plans.

Common Clinical Scenarios

Routine eye exams revealing abnormal findings, follow-up visits for monitoring CIS.

Billing Considerations

Ensure clear documentation of the diagnosis and any changes in the patient's condition over time.

Oncology

Documentation Requirements

Comprehensive treatment plans, pathology reports, and follow-up care documentation.

Common Clinical Scenarios

Referral for surgical intervention or radiation therapy for CIS.

Billing Considerations

Coordination with ophthalmology for accurate staging and treatment planning.

Coding Guidelines

Inclusion Criteria

Use D09.20 When
  • According to ICD
  • 10 coding guidelines, D09
  • 20 should be used when there is a confirmed diagnosis of carcinoma in situ of the eye without specification of the exact location
  • Coders must ensure that the diagnosis is supported by clinical documentation and that any relevant imaging or pathology reports are included

Exclusion Criteria

Do NOT use D09.20 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

66984CPT Code

Excimer laser photorefractive keratectomy

Clinical Scenario

Used in conjunction with D09.20 when surgical intervention is indicated.

Documentation Requirements

Document the indication for surgery and pre-operative assessments.

Specialty Considerations

Ophthalmologists must ensure that the procedure is justified based on the diagnosis.

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 ability to track and manage these conditions. D09.20 provides a clear designation for carcinoma in situ of the eye, facilitating better patient care and research.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of carcinoma in situ, improving the ability to track and manage these conditions. D09.20 provides a clear designation for carcinoma in situ of the eye, facilitating better patient care and research.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of carcinoma in situ, improving the ability to track and manage these conditions. D09.20 provides a clear designation for carcinoma in situ of the eye, facilitating better patient care and research.

Resources

Clinical References

  • •
    American Academy of Ophthalmology

Coding & Billing References

  • •
    American Academy of Ophthalmology

Frequently Asked Questions

What is carcinoma in situ of the eye?

Carcinoma in situ of the eye refers to a localized cancerous condition where abnormal cells are present in the epithelial layer of the eye without invading deeper tissues. It is often asymptomatic and requires careful monitoring.