D04.0

D04.0: Carcinoma in situ of skin of lip

Billable / specific codeICD-10-CM

D04.0 is a billable, specific ICD-10-CM code for carcinoma in situ of skin of lip. It is valid for submission on a claim.

Check D04.0 with the rest of the claim: free scrubber

Excludes2: not included here, but may coexist

The excluded condition is not part of this code, but a patient can have both. You may code both.

carcinoma in situ of vermilion border of lip (D00.01)

Excludes1 inherited from the categories above D04.0

A category’s note binds every code beneath it.

Written on D04: Carcinoma in situ of skin

erythroplasia of Queyrat (penis) NOS (D07.4)
melanoma in situ (D03.-)

Other codes that can never be billed with D04.0

Their own Excludes1 notes name this code, so the conflict is not listed above.

D00.0Carcinoma in situ of lip, oral cavity and pharynx

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Medicare coverage

D04.0 is named in 35 Medicare coverage policies: 35 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A52480Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) - Policy Article
A53883Billing and Coding: Mohs Micrographic Surgery (MMS)
A54768Billing and Coding: Cardiac Blood Pool Imaging (Multiple Gated Acquisition Scanning- MUGA, Ventriculography) When Performed in Conjunction with Cardiotoxic Chemotherapy
A56346Billing and Coding: Removal of Benign and Malignant Skin Lesions

Code history

Unchanged in every release from FY2024 to FY2027.