D01.3 ICD-10-CM Code: Carcinoma in situ of anus and anal canal
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)
D01.3
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceCarcinoma in situ of anus and anal canal
Abnormal cells found in the anus or anal canal that have the potential to become cancer but have not yet invaded deeper tissues.
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
Official- Anal intraepithelial neoplasia III [AIN III]
- Severe dysplasia of anus
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for D01.3 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for D01.3 in this effective period.
Excludes 1
Official- anal intraepithelial neoplasia I and II [AIN I and AIN II] (K62.82)
- carcinoma in situ of anal margin (D04.5)
- carcinoma in situ of anal skin (D04.5)
- carcinoma in situ of perianal skin (D04.5)
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for D01.3 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for D01.3 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for D01.3 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 D01.3 an HCC code?
No. D01.3 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
- Code
- D01.3
- Description
- Carcinoma in situ of anus and anal canal
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF
- —
- Billable
- Yes
- Payment year
- 2026
Coder workflow notes
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This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
D01.3 is the ICD-10-CM diagnosis code for carcinoma in situ of anus and anal canal. Abnormal cells found in the anus or anal canal that have the potential to become cancer but have not yet invaded deeper tissues. D01.3 sits in the ICD-10-CM chapter for neoplasms (c00-d49), within the section covering in situ neoplasms (d00-d09).
D01.3 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 anal location versus rectal location to ensure correct code selection.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for D01.3 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify documentation specifies anal location versus rectal location to ensure correct code selection
- •This code includes both the anal verge and anal canal