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D03.70 ICD-10-CM Code: Melanoma in situ of unspecified lower limb, including hip

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

D03.70

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

Melanoma in situ of unspecified lower limb, including hip

Early-stage melanoma confined to the skin surface on a lower limb or hip area when the specific side (right or left) is not documented.

Buddy the Bee presenting code insight

Buddy Insight

Melanoma in situ of an unspecified lower limb including hip represents early melanocytic malignancy confined to the epidermis of the leg, thigh, foot, or hip region when laterality is not documented.

CMS-HCC V28

HCC 23

RAF 0.251

CMS-HCC V24

HCC 12

RAF 0.150

ACA/HHS

0

0

RAF 0

ESRD/PACE

HCC 12

RAF 0.0

RXHCC

HCC 22

RAF 0.0

Code Trumping

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Code Book Path

Official
D03Melanoma in situ
D03.7Melanoma in situ of lower limb, including hip
D03.70Melanoma in situ of unspecified lower limb, including hip

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for D03.70 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for D03.70 in this effective period.

Related Child Codes

Official
D03.71Melanoma in situ of right lower limb, including hip
D03.72Melanoma in situ of left lower limb, including hip

Includes

Official

ICD-10-CM does not list Includes notes for D03.70 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for D03.70 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for D03.70 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for D03.70 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for D03.70 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
Biopsy-confirmed melanoma in situ of the lower limb.
Laterality should always be documented to allow use of D03.71 (right) or D03.72 (left).
Specify the exact location on the lower extremity (hip, thigh, knee, leg, ankle, foot) and document margin status and follow-up plan.

MEAT Support

HCC Buddy guidance
Biopsy-confirmed melanoma in situ of the lower limb.
Laterality should always be documented to allow use of D03.71 (right) or D03.72 (left).
Specify the exact location on the lower extremity (hip, thigh, knee, leg, ankle, foot) and document margin status and follow-up plan.

Audit Caution

HCC Buddy guidance
Always query for laterality before accepting this unspecified code.
The hip is included in the lower limb codes, not the trunk codes.
If a patient has melanoma in situ on both legs, code each side separately with the laterality-specific codes.
Foot/sole melanoma in situ may be the acral lentiginous subtype and requires careful pathologic assessment.

Common Mistakes

HCC Buddy guidance
D03.71 (right lower limb) and D03.72 (left lower limb) are preferred when laterality is documented
D03.60 (unspecified upper limb) is for arm locations
C43.70-C43.72 (invasive melanoma of lower limb) indicate dermal invasion.

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 D03.70 an HCC code?

Yes. D03.70 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

V28HCC 23, Melanoma and Other Skin Cancers
0.251
V24HCC 12, Breast, Prostate, and Other Cancers and Tumors
0.150
ESRDHCC 12, Breast, Prostate, and Other Cancers and Tumors
0.000
RxHCCHCC 22, Cancer, Other Specified Sites
0.000

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 D03.70

For D03.70to 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 D03.70 during that encounter, not just copy-forwarded from a problem list.

What This Code Means

D03.70 is the ICD-10-CM diagnosis code for melanoma in situ of unspecified lower limb, including hip. Early-stage melanoma confined to the skin surface on a lower limb or hip area when the specific side (right or left) is not documented. D03.70 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, D03.70 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, D03.70 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 more specific codes instead. Because D03.70 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 D03.70 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Use this code only when laterality is not specified; if right or left is documented, use more specific codes instead
  • Always attempt to determine which leg/hip is affected and document for proper treatment planning

Clinical Significance

Melanoma in situ of an unspecified lower limb including hip represents early melanocytic malignancy confined to the epidermis of the leg, thigh, foot, or hip region when laterality is not documented. The lower extremities are common melanoma sites, particularly in women. Detection at the in situ stage allows curative excision without the risks associated with invasive disease.

Documentation Requirements

  • Biopsy-confirmed melanoma in situ of the lower limb.
  • Laterality should always be documented to allow use of D03.71 (right) or D03.72 (left).
  • Specify the exact location on the lower extremity (hip, thigh, knee, leg, ankle, foot) and document margin status and follow-up plan.

Commonly Confused Codes

  • D03.71 (right lower limb) and D03.72 (left lower limb) are preferred when laterality is documented
  • D03.60 (unspecified upper limb) is for arm locations
  • C43.70-C43.72 (invasive melanoma of lower limb) indicate dermal invasion.

Child Codes

Code Hierarchy

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