D07.5

D07.5: Carcinoma in situ of prostate

Billable / specific codeICD-10-CM

D07.5 is a billable, specific ICD-10-CM code for carcinoma in situ of prostate. It is valid for submission on a claim.

Check D07.5 with the rest of the claim: free scrubber

Excludes1: never code together

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

dysplasia (mild) (moderate) of prostate (N42.3-)
prostatic intraepithelial neoplasia II [PIN II] (N42.3-)

Inclusion terms

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

Prostatic intraepithelial neoplasia III (PIN III)
Severe dysplasia of prostate

Excludes1 inherited from the categories above D07.5

A category’s note binds every code beneath it.

Written on D07: Carcinoma in situ of other and unspecified genital organs

melanoma in situ of trunk (D03.5)

Other codes that can never be billed with D07.5

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

N42.31Prostatic intraepithelial neoplasia
D04.5Carcinoma in situ of skin of trunk

Risk adjustment

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

Medicare coverage

D07.5 is named in 17 Medicare coverage policies: 17 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

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