What is ICD-10 code D03.22?

D03.22 is the ICD-10-CM diagnosis code for Melanoma in situ of left ear and external auricular canal. It belongs to the ICD-10-CM chapter for neoplasms (c00-d49). D03.22 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. D03.22 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. D03.22 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. D03.22 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

Which HCC does D03.22 map to under V28?

D03.22 maps to CMS-HCC V28 23 (Prostate, Breast, and Other Cancers and Tumors). The category number and label come from the CMS-HCC V28 model file for payment year 2026.

What does D03.22 pay in RAF?

D03.22 carries a community, non-dual, aged (CNA) RAF weight of 0.186 under CMS-HCC V28 for payment year 2026. The weight comes from the CMS V28 relative-factor file, not a hand-typed table.

What is the V28 vs V24 difference for D03.22?

CMS phased in the V28 risk adjustment model over payment years 2024 (33%), 2025 (67%), and 2026 (100%), replacing V24. V28 consolidates HCC categories, removes some lower-acuity conditions, and recalibrates RAF weights across the entire model. For D03.22, V28 maps to Prostate, Breast, and Other Cancers and Tumors at RAF 0.186 while V24 mapped to Breast, Prostate, and Other Cancers and Tumors at RAF 0.150. Both models can still appear in legacy data and in payer-specific lookback periods.

What documentation supports D03.22?

Ensure laterality is correctly documented as left ear (D03.22) versus right ear (D03.21) or unspecified (D03.20) to avoid claim denials Verify that the melanoma is confirmed as 'in situ' (non-invasive) rather than invasive melanoma, as this affects staging and treatment decisions Because D03.22 maps to a payment HCC, the documentation must also satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's risk adjustment score. See the MEAT criteria checklist at /meat-criteria for what Monitor, Evaluate, Assess, or Treat looks like in a note. MEAT is generic documentation evidence, not a payer-specific rule.

2026 ICD-10-CM D03.22: Melanoma in situ of left ear

D03.22 maps to CMS-HCC V28 23 (RAF 0.186). Documentation must support MEAT. MEAT criteria · RAF calculator · HCC coding software

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Code lookupD03.22Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Neoplasms (C00-D49) / In situ neoplasms (D00-D09)

D03.22

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Melanoma in situ of left ear and external auricular canal

This is an early-stage skin cancer (melanoma) found on the left ear or the canal leading into the ear that has not yet spread to deeper layers of skin or other parts of the body. It is considered a precancerous condition that requires treatment to prevent progression.

Buddy Insight

Melanoma in situ of the left ear and external auricular canal is an early melanocytic malignancy confined to the epidermal layer of the left ear.

CMS-HCC V28

Mapped

HCC 23

Prostate, Breast, and Other C...

RAF 0.186

CMS-HCC V24

Mapped

HCC 12

Breast, Prostate, and Other C...

RAF 0.150

ACA/HHS

Mapped

HCC 13

HHS-HCC 13

Varies by metal level

ESRD/PACE

Mapped

HCC 12

Breast, Prostate, and Other C...

RAF 0.045

RXHCC

Mapped

HCC 22

Cancer, Other Specified Sites

RAF 0.124

Code Book Path

Official

D03Melanoma in situ

D03.2Melanoma in situ of ear and external auricular canal

D03.22Melanoma in situ of left ear and external auricular canal

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for D03.22 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for D03.22 in this effective period.

Related Child Codes

Official

D03.20Melanoma in situ of unspecified ear and external auricular canal

D03.21Melanoma in situ of right ear and external auricular canal

Includes

Official

ICD-10-CM does not list Includes notes for D03.22 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for D03.22 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for D03.22 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for D03.22 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for D03.22 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Pathologic confirmation of melanoma in situ with left-side laterality and epidermal confinement documented.

Specify the exact auricular subsite involved and margin status.

Follow-up documentation should include surveillance findings and any signs of recurrence.

MEAT Support

HCC Buddy guidance

Pathologic confirmation of melanoma in situ with left-side laterality and epidermal confinement documented.

Specify the exact auricular subsite involved and margin status.

Follow-up documentation should include surveillance findings and any signs of recurrence.

Audit Caution

HCC Buddy guidance

Verify left-sided laterality is clearly documented before assigning.

Do not assign if the pathology shows any evidence of dermal invasion.

If the patient has bilateral ear melanoma in situ, code both D03.21 and D03.22 separately.

Common Mistakes

HCC Buddy guidance

D03.21 (right ear) differs in laterality

D03.20 (unspecified ear) is less specific

C43.22 (invasive melanoma of left ear) indicates invasion beyond the epidermis

D04.2 (carcinoma in situ of ear) is a non-melanocytic in situ neoplasm.

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 D03.22 an HCC code?

Yes. D03.22 (Melanoma in situ of left ear and external auricular canal) maps to Prostate, Breast, and Other Cancers and Tumors under the CMS-HCC V28 risk adjustment model (and Breast, Prostate, and Other Cancers and Tumors under V24), with a community non-dual aged RAF of 0.186. It is billable for payment year 2026.

Coder answer: D03.22 is billable and maps to V28 HCC 23, Prostate, Breast, and Other Cancers and Tumors. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code: D03.22
Description: Melanoma in situ of left ear and external auricular canal
HCC (V28): HCC 23 — Prostate, Breast, and Other Cancers and Tumors
RAF: 0.186
Billable: Yes
Payment year: 2026

HCC Category Mapping

V28HCC 23, Prostate, Breast, and Other Cancers and Tumors

0.186

V24HCC 12, Breast, Prostate, and Other Cancers and Tumors

0.150

ESRDHCC 12, Breast, Prostate, and Other Cancers and Tumors

0.045

RxHCCHCC 22, Cancer, Other Specified Sites

0.124

Each model's RAF is its CMS base weight for that model's standard population, so weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.

Work D03.22 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for D03.22

For D03.22 to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically, it has to be re-documented and supported each calendar year.

MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
EEvaluate: test results, medication response, or physical findings reviewed by the provider
AAssess: explicit mention in the assessment or plan with acknowledgment of status
TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis

Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed D03.22 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

D03.22 is the ICD-10-CM diagnosis code for melanoma in situ of left ear and external auricular canal. This is an early-stage skin cancer (melanoma) found on the left ear or the canal leading into the ear that has not yet spread to deeper layers of skin or other parts of the body. It is considered a precancerous condition that requires treatment to prevent progression. D03.22 sits in the ICD-10-CM chapter for neoplasms (c00-d49), within the section covering in situ neoplasms (d00-d09).

Under the CMS-HCC V28 risk adjustment model, D03.22 maps to Prostate, Breast, and Other Cancers and Tumors (HCC 23) with a community, non-dual, aged base RAF weight of 0.186. Under the older CMS-HCC V24 model, D03.22 maps to Breast, Prostate, and Other Cancers and Tumors (HCC 12) with a community, non-dual, aged base RAF weight of 0.150. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition.

Ensure laterality is correctly documented as left ear (D03.22) versus right ear (D03.21) or unspecified (D03.20) to avoid claim denials. Because D03.22 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for D03.22 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Ensure laterality is correctly documented as left ear (D03.22) versus right ear (D03.21) or unspecified (D03.20) to avoid claim denials
•Verify that the melanoma is confirmed as 'in situ' (non-invasive) rather than invasive melanoma, as this affects staging and treatment decisions

Clinical Significance

Melanoma in situ of the left ear and external auricular canal is an early melanocytic malignancy confined to the epidermal layer of the left ear. Like other auricular melanomas in situ, it benefits from early detection and complete excision, offering an excellent prognosis when treated appropriately. The complex anatomy of the ear may necessitate Mohs surgery or staged excision for optimal margin control.

Documentation Requirements

✓Pathologic confirmation of melanoma in situ with left-side laterality and epidermal confinement documented.
✓Specify the exact auricular subsite involved and margin status.
✓Follow-up documentation should include surveillance findings and any signs of recurrence.