D03.60 ICD-10-CM Code: Melanoma in situ of unspecified upper limb, including shoulder
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)
D03.60
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceMelanoma in situ of unspecified upper limb, including shoulder
Early-stage melanoma confined to the skin surface on an upper limb or shoulder area when the specific side (right or left) is not documented.
Buddy Insight
Melanoma in situ of an unspecified upper limb represents early melanocytic malignancy confined to the epidermis of the arm, forearm, hand, or shoulder when laterality is not documented.
CMS-HCC V28
MappedHCC 23
RAF 0.251
CMS-HCC V24
MappedHCC 12
RAF 0.150
ACA/HHS
00
RAF 0
ESRD/PACE
MappedHCC 12
RAF 0.0
RXHCC
MappedHCC 22
RAF 0.0
Code Trumping
Basket needed
Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for D03.60 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for D03.60 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for D03.60 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for D03.60 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for D03.60 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for D03.60 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for D03.60 in this effective period.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
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 D03.60 an HCC code?
Yes. D03.60 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 D03.60
For D03.60to 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 D03.60 during that encounter, not just copy-forwarded from a problem list.
What This Code Means
D03.60 is the ICD-10-CM diagnosis code for melanoma in situ of unspecified upper limb, including shoulder. Early-stage melanoma confined to the skin surface on an upper limb or shoulder area when the specific side (right or left) is not documented. D03.60 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, D03.60 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, D03.60 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 only when laterality is not specified; if right or left is documented, use D03.61 or D03.62 instead. Because D03.60 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 D03.60 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
Clinical Significance
Melanoma in situ of an unspecified upper limb represents early melanocytic malignancy confined to the epidermis of the arm, forearm, hand, or shoulder when laterality is not documented. Upper extremity melanomas have generally better prognosis than trunk or head/neck melanomas when they progress to invasive disease. The in situ stage offers near-complete curability with appropriate excision.
Documentation Requirements
- ✓Biopsy-confirmed melanoma in situ with upper limb location documented. Laterality (right vs. left) should always be specified to enable use of D03.61 or D03.
- ✓Document the exact subsite (shoulder, upper arm, forearm, hand), margin status, and follow-up plan.