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v1.0.0
ICD-10 Guide
ICD-10 CodesD22.121

D22.121

Billable

Melanocytic nevi of left upper eyelid, including canthus

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

Code Description

ICD-10 D22.121 is a billable code used to indicate a diagnosis of melanocytic nevi of left upper eyelid, including canthus.

Key Diagnostic Point:

Melanocytic nevi, commonly referred to as moles, are benign tumors of melanocytes, the pigment-producing cells in the skin. The left upper eyelid, including the canthus, is a specific anatomical location where these nevi can occur. These lesions are typically asymptomatic and may vary in color, size, and shape. While most melanocytic nevi are benign, they can sometimes be mistaken for malignant lesions, necessitating careful evaluation. Diagnosis is usually made through clinical examination, and in some cases, a biopsy may be performed to rule out malignancy. Management often involves monitoring for changes in size, shape, or color, and surgical excision may be considered if there are concerns about malignancy or for cosmetic reasons. Follow-up care is essential to ensure that any changes in the nevi are promptly addressed, and patients should be educated about skin monitoring practices.

Code Complexity Analysis

Complexity Rating: Low

Low Complexity

Complexity Factors

  • Specificity of the anatomical location (left upper eyelid)
  • Benign nature of the condition
  • Clear diagnostic criteria
  • Low likelihood of complications

Audit Risk Factors

  • Misidentification of the lesion as malignant
  • Inadequate documentation of the lesion's characteristics
  • Failure to document follow-up care
  • Incorrect coding of the anatomical site

Specialty Focus

Medical Specialties

Dermatology

Documentation Requirements

Detailed description of the lesion, including size, color, and any changes over time.

Common Clinical Scenarios

Routine skin checks, evaluation of changing moles, and cosmetic consultations.

Billing Considerations

Ensure clear documentation of benign vs. malignant characteristics to avoid miscoding.

Ophthalmology

Documentation Requirements

Assessment of visual impact and any associated symptoms.

Common Clinical Scenarios

Evaluation of eyelid lesions, management of cosmetic concerns, and surgical excision.

Billing Considerations

Document any potential impact on vision or eyelid function.

Coding Guidelines

Inclusion Criteria

Use D22.121 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the lesion's characteristics and location
  • Include any relevant patient history and follow
  • up plans

Exclusion Criteria

Do NOT use D22.121 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

11400CPT Code

Excision, benign lesion

Clinical Scenario

Used when a nevus is excised for cosmetic reasons.

Documentation Requirements

Document the size of the lesion and the reason for excision.

Specialty Considerations

Dermatologists should ensure clear documentation of the benign nature of the lesion.

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 data collection and reimbursement processes.

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 data collection and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

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 can arise from these cells. Accurate diagnosis is crucial to determine the appropriate coding and management.