ICD-10 Coding for Breast DCIS(C50.312, D05.10)
Complete ICD-10-CM coding and documentation guide for Breast DCIS. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Breast DCIS
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| C50.312 | Malignant neoplasm of upper-outer quadrant of left female breast | Use when DCIS is confirmed in the upper outer quadrant of the left breast. |
|
| D05.10 | Intraductal carcinoma in situ of unspecified breast | Use when DCIS is confirmed but specific site or laterality is not documented. |
|
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 breast DCIS
Essential facts and insights about Breast DCIS
Primary ICD-10-CM Codes for breast dcis
Decision Criteria
clinical Criteria
- Confirmed DCIS in specified quadrant
documentation Criteria
- Clear documentation of tumor site and laterality
Applicable To
- DCIS of upper outer quadrant of left breast
Excludes
- Invasive breast cancer
Clinical Validation Requirements
- Biopsy confirmation of DCIS
- Imaging showing tumor location
Code-Specific Risks
- Incorrect laterality documentation
- Misclassification as invasive cancer
Coding Notes
- Ensure documentation specifies laterality and quadrant to avoid unspecified codes.
D05.10 - Intraductal carcinoma in situ of unspecified breast
Use when DCIS is confirmed but specific site or laterality is not documented.
Applicable To
- DCIS when site is not specified
Excludes
- Invasive breast cancer
Clinical Validation Requirements
- Pathology report confirming DCIS without specific site
Coding Notes
Encourage specificity in documentation to avoid using unspecified codes.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Personal history of malignant neoplasm of breast
Z85.3Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Breast DCIS to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code C50.312.
Impact
Clinical: Leads to incorrect treatment planning., Regulatory: Increases risk of non-compliance., Financial: Potential for denied claims.
Mitigation Strategy
Use standardized templates, Regular training on documentation
Impact
Reimbursement: May lead to lower reimbursement rates., Compliance: Increases risk of audit failures., Data Quality: Reduces accuracy of clinical data.
Mitigation Strategy
Ensure documentation specifies laterality and quadrant for accurate coding.
Impact
High use of unspecified codes can trigger audits.
Mitigation Strategy
Implement documentation checks to ensure specificity.
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 Breast DCIS, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Breast DCIS
Use these documentation templates to ensure complete and accurate documentation for Breast DCIS. These templates include all required elements for proper coding and billing.
DCIS Diagnosis Documentation
Specialty: OncologyRequired Elements
- Laterality
- Quadrant
- Size
- Margins
- Necrosis
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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