Is D04.5 a billable ICD-10-CM code?

Yes. D04.5 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does D04.5 sit in the tabular list?

Neoplasms (C00-D49), in the block In situ neoplasms (D00-D09).

What cannot be coded together with D04.5?

D04.5 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

D04.5

D04.5 — Carcinoma in situ of skin of trunk

Billable / specific codeICD-10-CM

D04.5 is a billable, specific ICD-10-CM code for carcinoma in situ of skin of trunk. It is valid for submission on a claim.

Excludes1 — never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

carcinoma in situ of anus NOS (D01.3)
carcinoma in situ of scrotum (D07.61)
carcinoma in situ of skin of genital organs (D07.-)

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Carcinoma in situ of anal margin
Carcinoma in situ of anal skin
Carcinoma in situ of perianal skin
Carcinoma in situ of skin of breast

Other codes that can never be billed with D04.5

These codes carry an Excludes1 note pointing at D04.5. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading D04.5 alone.

D05Carcinoma in situ of breast
D01.3Carcinoma in situ of anus and anal canal

Risk adjustment

D04.5 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

Medicare coverage

D04.5 is named in 39 Medicare coverage policies — 39 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

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

Related codes at this level

Codes that share D04. If D04.5 is not quite right, the correct code is usually one of these.

Questions about D04.5

Is D04.5 a billable ICD-10-CM code?: Yes. D04.5 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does D04.5 sit in the tabular list?: Neoplasms (C00-D49), in the block In situ neoplasms (D00-D09).
What cannot be coded together with D04.5?: D04.5 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.