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ICD-10 Guide
ICD-10 CodesD22.11

D22.11

Billable

Melanocytic nevi of right eyelid, including canthus

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

Code Description

ICD-10 D22.11 is a billable code used to indicate a diagnosis of melanocytic nevi of right eyelid, including canthus.

Key Diagnostic Point:

Melanocytic nevi, commonly referred to as moles, are benign tumors that arise from melanocytes, the pigment-producing cells in the skin. When located on the right eyelid, including the canthus, these nevi can vary in size, color, and shape. They are typically asymptomatic but may be of cosmetic concern to patients. Melanocytic nevi can be classified into congenital and acquired types, with the latter being more common. While most nevi are benign, changes in size, color, or shape may warrant further evaluation to rule out malignant transformation. Management often involves monitoring for changes, and if necessary, surgical excision may be performed for cosmetic reasons or if there are concerns regarding malignancy. Follow-up care is essential to monitor for any changes in the nevi and to provide reassurance to the patient regarding their benign nature.

Code Complexity Analysis

Complexity Rating: Low

Low Complexity

Complexity Factors

  • Specificity of the location (right eyelid, including canthus)
  • Benign nature of the neoplasm
  • Clear differentiation from malignant lesions
  • Standard documentation practices for benign neoplasms

Audit Risk Factors

  • Inadequate documentation of the benign nature of the nevi
  • Failure to note the specific location of the nevi
  • Lack of follow-up documentation for monitoring
  • Misclassification as malignant lesions

Specialty Focus

Medical Specialties

Dermatology

Documentation Requirements

Detailed descriptions of the nevi, including size, color, and any changes over time.

Common Clinical Scenarios

Evaluation of new or changing nevi, cosmetic removal of nevi.

Billing Considerations

Ensure clear documentation of the benign nature and any patient concerns addressed.

Ophthalmology

Documentation Requirements

Assessment of the nevi's impact on vision and surrounding structures.

Common Clinical Scenarios

Monitoring nevi near the eye, surgical intervention if affecting vision.

Billing Considerations

Document any visual symptoms or concerns related to the nevi.

Coding Guidelines

Inclusion Criteria

Use D22.11 When
  • According to ICD
  • 10 guidelines, D22
  • 11 should be used when documenting melanocytic nevi specifically located on the right eyelid
  • It is important to ensure that the nevi are confirmed as benign through clinical evaluation

Exclusion Criteria

Do NOT use D22.11 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

11400CPT Code

Excision, benign lesion

Clinical Scenario

Used when a benign nevus is excised for cosmetic reasons.

Documentation Requirements

Document the size, location, and reason for excision.

Specialty Considerations

Ensure that the excision is clearly linked to the diagnosis of D22.11.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of conditions like melanocytic nevi, improving the accuracy of patient records and facilitating better management of benign skin lesions.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like melanocytic nevi, improving the accuracy of patient records and facilitating better management of benign skin lesions.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of conditions like melanocytic nevi, improving the accuracy of patient records and facilitating better management of benign skin lesions.

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 difference between a melanocytic nevus and melanoma?

A melanocytic nevus is a benign growth of melanocytes, while melanoma is a malignant tumor that arises from melanocytes. Nevi are usually stable and asymptomatic, whereas melanoma may exhibit changes in size, color, or shape and can be life-threatening.