D00.03 ICD-10-CM Code: Carcinoma in situ of gingiva and edentulous alveolar ridge
HCC Buddy Code Card
Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.
FY 2026 Apr update / Neoplasms (C00-D49) / In situ neoplasms (D00-D09)
D00.03
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceCarcinoma in situ of gingiva and edentulous alveolar ridge
This code describes abnormal cells found in the gums or the ridge of bone where teeth are missing that have the potential to become cancer if not treated. These cells are confined to the surface layer and have not yet invaded deeper tissues.
CMS-HCC V28
00
RAF 0
CMS-HCC V24
00
RAF 0
ACA/HHS
00
RAF 0
ESRD/PACE
00
RAF 0
RXHCC
00
RAF 0
Code Trumping
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Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for D00.03 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for D00.03 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for D00.03 in this effective period.
Excludes 1
Official- carcinoma in situ of aryepiglottic fold or interarytenoid fold, laryngeal aspect (D02.0)
- carcinoma in situ of epiglottis NOS (D02.0)
- carcinoma in situ of epiglottis suprahyoid portion (D02.0)
- carcinoma in situ of skin of lip (D03.0, D04.0)
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for D00.03 in this effective period.
Use Additional
Official- code to identify:
- exposure to environmental tobacco smoke (Z77.22)
- exposure to tobacco smoke in the perinatal period (P96.81)
- history of tobacco dependence (Z87.891)
- occupational exposure to environmental tobacco smoke (Z57.31)
Code Also
OfficialICD-10-CM does not list Code Also instructions for D00.03 in this effective period.
Buddy Documentation Tip
Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.
Is D00.03 an HCC code?
No. D00.03 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
D00.03 is the ICD-10-CM diagnosis code for carcinoma in situ of gingiva and edentulous alveolar ridge. This code describes abnormal cells found in the gums or the ridge of bone where teeth are missing that have the potential to become cancer if not treated. These cells are confined to the surface layer and have not yet invaded deeper tissues. D00.03 sits in the ICD-10-CM chapter for neoplasms (c00-d49), within the section covering in situ neoplasms (d00-d09).
D00.03 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.
Verify documentation specifies the location as gingiva (gums) or edentulous alveolar ridge (toothless jaw bone area) to ensure correct code selection.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for D00.03 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify documentation specifies the location as gingiva (gums) or edentulous alveolar ridge (toothless jaw bone area) to ensure correct code selection
- •Confirm this is carcinoma in situ (pre-cancerous/non-invasive) and not invasive carcinoma, as invasive cases require different coding