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ICD-10 Guide
ICD-10 CodesD22.9

D22.9

Billable

Melanocytic nevi, unspecified

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

Code Description

ICD-10 D22.9 is a billable code used to indicate a diagnosis of melanocytic nevi, unspecified.

Key Diagnostic Point:

Melanocytic nevi, commonly known as moles, are benign tumors of melanocytes, the cells responsible for producing melanin, the pigment that gives skin its color. These nevi can appear anywhere on the body and vary in size, shape, and color. While most melanocytic nevi are harmless, they can sometimes change in appearance, which may raise concerns for malignancy. The unspecified designation indicates that the nevi have not been classified into more specific categories, such as congenital or acquired nevi. Clinically, these lesions are typically asymptomatic but may be monitored for changes that could indicate potential skin cancer. Management often involves regular dermatological examinations, especially for patients with multiple nevi or a family history of skin cancer. If a nevus shows signs of atypical features, such as asymmetry, irregular borders, or color variation, further evaluation or excision may be warranted. 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 their skin health.

Code Complexity Analysis

Complexity Rating: Low

Low Complexity

Complexity Factors

  • Lack of specificity in the diagnosis
  • Commonality of the condition
  • Standard management protocols
  • Minimal documentation requirements

Audit Risk Factors

  • Inadequate documentation of the nevus characteristics
  • Failure to document follow-up care
  • Misclassification of nevi as malignant
  • Lack of patient education records

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 examinations, monitoring of existing nevi, and evaluation of new lesions.

Billing Considerations

Ensure that any atypical features are documented to justify further intervention or monitoring.

Primary Care

Documentation Requirements

Basic descriptions of nevi and any patient-reported changes.

Common Clinical Scenarios

Annual skin checks, patient concerns about new or changing moles.

Billing Considerations

Educate patients on self-examination and when to seek further evaluation.

Coding Guidelines

Inclusion Criteria

Use D22.9 When
  • According to ICD
  • 10 guidelines, D22
  • 9 should be used when the specific type of melanocytic nevus is not documented
  • Coders should ensure that the diagnosis is supported by clinical findings and that any related procedures are appropriately linked

Exclusion Criteria

Do NOT use D22.9 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

11100CPT Code

Biopsy of skin, excisional

Clinical Scenario

When a suspicious nevus is excised for further evaluation.

Documentation Requirements

Document the reason for excision and the characteristics of the nevus.

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 skin lesions, but D22.9 remains a useful code for unspecified melanocytic nevi. It emphasizes the importance of thorough documentation to support the diagnosis.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of skin lesions, but D22.9 remains a useful code for unspecified melanocytic nevi. It emphasizes the importance of thorough documentation to support the diagnosis.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of skin lesions, but D22.9 remains a useful code for unspecified melanocytic nevi. It emphasizes the importance of thorough documentation to support the diagnosis.

Resources

Clinical References

  • •
    American Academy of Dermatology

Coding & Billing References

  • •
    American Academy of Dermatology

Frequently Asked Questions

When should I use D22.9 instead of a more specific code?

D22.9 should be used when the specific type of melanocytic nevus is not documented or when the provider has not specified the location or characteristics of the nevus.