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v1.0.0
ICD-10 Guide
ICD-10 CodesD22.6

D22.6

Billable

Melanocytic nevi of upper limb, including shoulder

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

Code Description

ICD-10 D22.6 is a billable code used to indicate a diagnosis of melanocytic nevi of upper limb, including shoulder.

Key Diagnostic Point:

Melanocytic nevi, commonly known as moles, are benign tumors of melanocytes, the cells responsible for producing melanin in the skin. The upper limb, including the shoulder, is a common site for these nevi to develop. They can vary in size, shape, and color, and are typically asymptomatic. Melanocytic nevi are usually classified as congenital or acquired, with acquired nevi being more prevalent in adults. While most nevi are benign, changes in their appearance can indicate potential malignancy, necessitating careful monitoring. Management typically involves observation, but excision may be warranted if there are concerns about atypical features or changes in the nevus. Regular skin examinations are recommended, especially for individuals with multiple nevi or a family history of skin cancer. The presence of melanocytic nevi is also a risk factor for the development of melanoma, making awareness and education about skin changes crucial for patients.

Code Complexity Analysis

Complexity Rating: Low

Low Complexity

Complexity Factors

  • Specificity of the code for upper limb nevi
  • Clear clinical guidelines for diagnosis
  • Low likelihood of complications
  • Standard management protocols

Audit Risk Factors

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

Specialty Focus

Medical Specialties

Dermatology

Documentation Requirements

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

Common Clinical Scenarios

Routine skin checks, excision of atypical nevi, and patient education on skin monitoring.

Billing Considerations

Ensure to document any family history of skin cancer and patient’s skin type.

Oncology

Documentation Requirements

Comprehensive history of the nevus, including any previous biopsies or treatments.

Common Clinical Scenarios

Management of patients with a history of melanoma or atypical nevi.

Billing Considerations

Document any referrals for surgical intervention or dermatopathology.

Coding Guidelines

Inclusion Criteria

Use D22.6 When
  • According to ICD
  • 10 guidelines, D22
  • 6 should be used when documenting benign melanocytic nevi located specifically on the upper limb, including the shoulder
  • It is important to differentiate between benign nevi and malignant lesions

Exclusion Criteria

Do NOT use D22.6 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 due to changes in appearance.

Documentation Requirements

Document the size, location, and reason for excision.

Specialty Considerations

Dermatologists should ensure clear communication of the excision rationale.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of benign neoplasms, improving the accuracy of data collection and reimbursement processes for conditions like melanocytic nevi.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of benign neoplasms, improving the accuracy of data collection and reimbursement processes for conditions like melanocytic nevi.

Reimbursement & Billing Impact

reimbursement processes for conditions like melanocytic nevi.

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 D22.6 and D23.6?

D22.6 is specifically for melanocytic nevi, while D23.6 is used for other benign neoplasms of the skin. Accurate coding depends on the specific diagnosis.