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ICD-10 Guide
ICD-10 CodesD22.12

D22.12

Billable

Melanocytic nevi of left eyelid, including canthus

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

Code Description

ICD-10 D22.12 is a billable code used to indicate a diagnosis of melanocytic nevi of left eyelid, including canthus.

Key Diagnostic Point:

Melanocytic nevi, commonly known as moles, are benign tumors of melanocytes, the cells responsible for pigment production in the skin. When located on the left eyelid, including the canthus, these nevi can vary in appearance, size, and color. They are typically asymptomatic and may be present at birth or develop over time. While most melanocytic nevi are benign, changes in size, shape, or color can indicate potential malignancy, necessitating careful monitoring. Diagnosis is primarily clinical, often supported by dermatoscopic examination. Management usually involves observation, but excision may be warranted if there are concerns about atypical features or cosmetic reasons. Follow-up is essential to monitor for any changes that could suggest malignant transformation. Regular skin examinations are recommended, especially for individuals with multiple nevi or a family history of skin cancer.

Code Complexity Analysis

Complexity Rating: Low

Low Complexity

Complexity Factors

  • Specificity of the location (left eyelid, including canthus)
  • Benign nature of the nevi
  • Commonality of the condition in the general population
  • Clear diagnostic criteria

Audit Risk Factors

  • Inadequate documentation of the nevi's characteristics
  • Failure to note changes in size or appearance
  • Lack of follow-up notes
  • Misclassification of benign nevi as malignant

Specialty Focus

Medical Specialties

Dermatology

Documentation Requirements

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

Common Clinical Scenarios

Routine skin checks, excision of atypical nevi, and management of multiple nevi.

Billing Considerations

Ensure accurate documentation of any changes in nevi to support coding and management decisions.

Ophthalmology

Documentation Requirements

Documentation of visual acuity, any impact on vision, and the location of the nevi.

Common Clinical Scenarios

Assessment of nevi affecting the eyelid or canthus, potential surgical intervention.

Billing Considerations

Consideration of cosmetic implications and potential surgical risks when coding for procedures.

Coding Guidelines

Inclusion Criteria

Use D22.12 When
  • Follow ICD
  • CM guidelines for coding neoplasms, ensuring accurate documentation of the benign nature of the nevi
  • Include details about the location and any relevant patient history

Exclusion Criteria

Do NOT use D22.12 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

11400CPT Code

Excision, benign lesion

Clinical Scenario

Used when excising a benign nevus on the eyelid.

Documentation Requirements

Document the size of the lesion and the method of excision.

Specialty Considerations

Ensure the procedure is justified based on clinical findings.

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 typically stable, whereas melanoma may show changes in size, shape, or color.