D00.05 ICD-10-CM Code: Carcinoma in situ of hard palate
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)
D00.05
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceCarcinoma in situ of hard palate
This code describes an early stage of cancer development in the hard palate (the roof of the mouth), where abnormal cells are present but have not yet invaded deeper tissues or spread to other areas. It represents a precancerous condition that requires monitoring and treatment to prevent progression to invasive cancer.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
N/A—
Not mapped
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for D00.05 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for D00.05 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for D00.05 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 D00.05 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 D00.05 in this effective period.
Buddy Documentation Tip
Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →
Is D00.05 an HCC code?
No. D00.05 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
- Code
- D00.05
- Description
- Carcinoma in situ of hard palate
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF
- —
- Billable
- Yes
- Payment year
- 2026
Coder workflow notes
Get the V28 RAF + MEAT cheat sheet
One printable page: confirm a code's V28 HCC status, its RAF weight, and the MEAT your note needs to make it stick. Free, no card.
Free PDF. No card. Unsubscribe anytime.
This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
D00.05 is the ICD-10-CM diagnosis code for carcinoma in situ of hard palate. This code describes an early stage of cancer development in the hard palate (the roof of the mouth), where abnormal cells are present but have not yet invaded deeper tissues or spread to other areas. It represents a precancerous condition that requires monitoring and treatment to prevent progression to invasive cancer. D00.05 sits in the ICD-10-CM chapter for neoplasms (c00-d49), within the section covering in situ neoplasms (d00-d09).
D00.05 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 hard palate location, as carcinoma in situ codes differ by anatomical site (D00.00-D00.09 for different palate locations).
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for D00.05 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify documentation specifies the hard palate location, as carcinoma in situ codes differ by anatomical site (D00.00-D00.09 for different palate locations)
- •Confirm this is truly 'in situ' (confined to the surface layer) and not invasive cancer, which would use different C-codes; query the provider if documentation is unclear about invasion status