D05.01
D05.01 — Lobular carcinoma in situ of right breast
Billable / specific codeICD-10-CMright
D05.01 is a billable, specific ICD-10-CM code for lobular carcinoma in situ of right breast. It is valid for submission on a claim.
Risk adjustment
D05.01 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
D05.01 is named in 37 Medicare coverage policies — 37 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A52399Billing and Coding: Denosumab (Prolia®, Xgeva®, Jubbonti®, Wyost®, Ospomyv™,Xbryk™,Bomyntra®, Conexxence®, Stoboclo®, Osenvelt®,Bildyos®, Bilprevda®)
- A52478External Breast Prostheses - Policy Article
- A52480Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) - Policy Article
- A52849Billing and Coding: Breast Imaging: Breast Echography (Sonography)/Breast MRI/Ductography
Related codes at this level
Codes that share D05.0. If D05.01 is not quite right, the correct code is usually one of these.
Questions about D05.01
- Is D05.01 a billable ICD-10-CM code?
- Yes. D05.01 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does D05.01 sit in the tabular list?
- Neoplasms (C00-D49), in the block In situ neoplasms (D00-D09).