ICD-10 Coding for Ductal Carcinoma In Situ(D05.1, D05.8)
Complete ICD-10-CM coding and documentation guide for Ductal Carcinoma In Situ. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Ductal Carcinoma In Situ
D05.0-D05.9Primary Range
Carcinoma in situ of breast
This range includes all types of carcinoma in situ of the breast, with specific codes for ductal carcinoma in situ.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| D05.1 | Intraductal carcinoma in situ of breast | Use when DCIS is confirmed via biopsy and documented with laterality. |
|
| D05.8 | Other specified carcinoma in situ of breast | Use for rare subtypes of DCIS not covered by D05.1. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for ductal carcinoma in situ
Essential facts and insights about Ductal Carcinoma In Situ
Primary ICD-10-CM Codes for ductal carcinoma in situ
Decision Criteria
clinical Criteria
- Biopsy confirms DCIS with specified laterality.
Applicable To
- DCIS
- Intraductal carcinoma
Clinical Validation Requirements
- Biopsy confirmation of intraductal carcinoma
- Imaging showing microcalcifications
- Pathology report indicating high nuclear grade
Code-Specific Risks
- Incorrect laterality coding
- Confusion with invasive carcinoma
Coding Notes
- Ensure documentation specifies laterality and nuclear grade.
D05.8 - Other specified carcinoma in situ of breast
Use for rare subtypes of DCIS not covered by D05.1.
Applicable To
- Pleomorphic DCIS
- Apocrine DCIS
Excludes
- Unspecified DCIS (D05.1)
Clinical Validation Requirements
- Pathology report specifying subtype of DCIS
Coding Notes
Ensure subtype is documented in pathology report.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Personal history of breast cancer
Z85.3Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Lobular carcinoma in situ
D05.0Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Ductal Carcinoma In Situ to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code D05.1.
Impact
Clinical: Impacts treatment decisions., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims.
Mitigation Strategy
Include nuclear grade in all pathology reports.
Impact
Reimbursement: May lead to incorrect billing and reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate patient records.
Mitigation Strategy
Verify laterality in the medical record before coding.
Impact
Using unspecified codes when specific information is available.
Mitigation Strategy
Ensure all documentation is reviewed for specificity before coding.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Ductal Carcinoma In Situ, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Ductal Carcinoma In Situ
Use these documentation templates to ensure complete and accurate documentation for Ductal Carcinoma In Situ. These templates include all required elements for proper coding and billing.
Pathology report for DCIS
Specialty: PathologyRequired Elements
- Laterality
- Nuclear grade
- Necrosis
- Margins
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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