D03.30
BillableMelanoma in situ of unspecified part of face
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is D03.30 an HCC code?
Yes. D03.30 maps to Melanoma and Other Skin Cancers under the CMS-HCC V28 risk adjustment model (and Breast, Prostate, and Other Cancers and Tumors under V24).
HCC Category Mapping
RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. 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.
MEAT Criteria for D03.30
For D03.30 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 D03.30 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
D03.30 is the ICD-10-CM diagnosis code for melanoma in situ of unspecified part of face. Early-stage melanoma (cancer cells confined to the skin surface) on an unspecified area of the face, before it has spread to deeper layers. D03.30 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, D03.30 maps to Melanoma and Other Skin Cancers (HCC 23) with a community, non-dual, aged base RAF weight of 0.251. Under the older CMS-HCC V24 model, D03.30 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.
Use this code when the specific facial location is not documented; if location is specified (cheek, nose, forehead), use D03.39 instead. Because D03.30 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 D03.30 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use this code when the specific facial location is not documented; if location is specified (cheek, nose, forehead), use D03.39 instead
- •Melanoma in situ is stage 0 and requires documentation of the exact anatomical site for proper treatment planning
Clinical Significance
Melanoma in situ of an unspecified part of the face represents the earliest stage of facial melanoma where atypical melanocytes remain confined to the epidermis, but the specific facial subsite is not documented. Facial melanoma in situ, particularly lentigo maligna type, is common in elderly patients with chronic sun damage and may present as an irregularly pigmented macule. The face presents unique surgical challenges due to cosmetic and functional considerations.
Documentation Requirements
- ✓Biopsy-confirmed melanoma in situ is required.
- ✓The provider should document the specific facial area involved (cheek, nose, forehead, temple, chin) to allow use of the more specific D03.39 code.
- ✓Include lesion dimensions, dermoscopic features, and margin status after treatment.