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ICD-10 Guide
ICD-10 CodesD22.61

D22.61

Billable

Melanocytic nevi of right upper limb, including shoulder

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

Code Description

ICD-10 D22.61 is a billable code used to indicate a diagnosis of melanocytic nevi of right 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 presence of melanocytic nevi on the right upper limb, including the shoulder, indicates localized growths that are typically asymptomatic and do not pose significant health risks. These nevi can vary in size, shape, and color, and while they are generally harmless, they may require monitoring for changes that could indicate malignancy. Management often involves regular dermatological evaluations, especially if there is a history of atypical nevi or skin cancer in the patient’s family. Treatment options may include observation, surgical excision, or dermatological procedures for cosmetic reasons. Follow-up care is essential to ensure that any changes in the nevi are promptly addressed, and patients are educated on self-examination techniques to monitor for any suspicious changes. Overall, melanocytic nevi are a common dermatological finding, and their management is straightforward, focusing on monitoring and patient education.

Code Complexity Analysis

Complexity Rating: Low

Low Complexity

Complexity Factors

  • Specificity of the location (right upper limb, including shoulder)
  • Clear distinction as a benign neoplasm
  • No additional modifiers required for coding
  • Low likelihood of complications or comorbidities

Audit Risk Factors

  • Inadequate documentation of the nevi's characteristics
  • Failure to note the location accurately
  • Lack of follow-up notes or management plans
  • Misclassification as malignant without proper evidence

Specialty Focus

Medical Specialties

Dermatology

Documentation Requirements

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

Common Clinical Scenarios

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

Billing Considerations

Ensure that any changes in the nevi are documented, and patient education on self-monitoring is included.

Primary Care

Documentation Requirements

Comprehensive patient history and physical examination findings related to skin lesions.

Common Clinical Scenarios

Annual skin exams, referrals to dermatology for suspicious lesions, and management of benign skin conditions.

Billing Considerations

Document any family history of skin cancer and patient concerns regarding nevi.

Coding Guidelines

Inclusion Criteria

Use D22.61 When
  • According to ICD
  • 10 coding guidelines, D22
  • 61 should be used when documenting benign melanocytic nevi located specifically on the right upper limb, including the shoulder
  • It is essential to ensure that the documentation supports the diagnosis and that the location is accurately recorded

Exclusion Criteria

Do NOT use D22.61 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 or due to patient concern.

Documentation Requirements

Document the size, location, and reason for excision.

Specialty Considerations

Dermatologists should ensure that the excision 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 tracking 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 tracking 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 tracking 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. Melanomas typically exhibit irregular borders, varied colors, and changes in size or shape, which are not characteristics of benign nevi.