D05.91
D05.91 — Unspecified type of carcinoma in situ of right breast
Billable / specific codeICD-10-CMright
D05.91 is a billable, specific ICD-10-CM code for unspecified type of carcinoma in situ of right breast. It is valid for submission on a claim.
Risk adjustment
D05.91 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
D05.91 is named in 31 Medicare coverage policies — 31 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
- A54768Billing and Coding: Cardiac Blood Pool Imaging (Multiple Gated Acquisition Scanning- MUGA, Ventriculography) When Performed in Conjunction with Cardiotoxic Chemotherapy
Related codes at this level
Codes that share D05.9. If D05.91 is not quite right, the correct code is usually one of these.
Questions about D05.91
- Is D05.91 a billable ICD-10-CM code?
- Yes. D05.91 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does D05.91 sit in the tabular list?
- Neoplasms (C00-D49), in the block In situ neoplasms (D00-D09).