ICD-10 Coding for DCIS(D05.1, D05.7)
Complete ICD-10-CM coding and documentation guide for DCIS. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to DCIS
D05-D05.9Primary Range
Carcinoma in situ of breast
This range includes all codes related to carcinoma in situ of the breast, specifically 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 |
|---|---|---|---|
| D05.1 | Intraductal carcinoma in situ of breast | Use for confirmed cases of DCIS with specified laterality. |
|
| D05.7 | Other specified intraductal carcinoma in situ | Use for DCIS cases with specific subtypes not classified under 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 DCIS
Essential facts and insights about DCIS
Primary ICD-10-CM Codes for dcis
Decision Criteria
clinical Criteria
- Histological confirmation of DCIS
documentation Criteria
- Clear documentation of DCIS subtype and laterality
Applicable To
- Comedo-type DCIS
- Cribriform-type DCIS
Excludes
- Invasive ductal carcinoma (C50.-)
Clinical Validation Requirements
- Histopathological confirmation of DCIS
- Mammography showing microcalcifications
Code-Specific Risks
- Risk of miscoding as invasive carcinoma
- Incorrect use without histological confirmation
Coding Notes
- Ensure laterality is specified to avoid unspecified coding.
D05.7 - Other specified intraductal carcinoma in situ
Use for DCIS cases with specific subtypes not classified under D05.1.
Applicable To
- Multifocal DCIS
Excludes
- Invasive ductal carcinoma (C50.-)
Clinical Validation Requirements
- Pathology report indicating multifocal DCIS
Coding Notes
Document specific subtype and laterality to ensure correct coding.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential 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 DCIS to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code D05.1.
Impact
Clinical: Potential mismanagement of patient care., Regulatory: Non-compliance with coding standards., Financial: Loss of reimbursement due to unspecified coding.
Mitigation Strategy
Implement mandatory fields for laterality in EHR systems.
Impact
Reimbursement: Potential overbilling if coded as invasive cancer., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate cancer registry data.
Mitigation Strategy
Ensure histological confirmation of in situ status before coding.
Impact
Use of unspecified codes when specific codes are applicable.
Mitigation Strategy
Ensure documentation supports the most specific code available.
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 DCIS, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for DCIS
Use these documentation templates to ensure complete and accurate documentation for DCIS. These templates include all required elements for proper coding and billing.
Pathology report for DCIS
Specialty: PathologyRequired Elements
- Laterality
- Histologic subtype
- Nuclear grade
- Necrosis presence
- Margin status
- Receptor status
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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