D03.71
BillableMelanoma in situ of right lower limb, including hip
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is D03.71 an HCC code?
Yes. D03.71 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 D03.71
For D03.71 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 D03.71 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
D03.71 is the ICD-10-CM diagnosis code for melanoma in situ of right lower limb, including hip. Early stage melanoma (cancer cells) found on the skin of the right leg or hip that has not yet invaded deeper layers of skin. D03.71 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, D03.71 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, D03.71 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.
This code is for melanoma in situ only; if invasive melanoma is present, use codes from D43 series instead. Because D03.71 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 D03.71 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This code is for melanoma in situ only; if invasive melanoma is present, use codes from D43 series instead
- •Ensure laterality is correctly documented as right; if location is unclear or bilateral, query the provider
Clinical Significance
Melanoma in situ of the right lower limb including hip is a non-invasive melanocytic neoplasm confined to the epidermis of the right leg, thigh, foot, or hip. Lower extremity melanoma is the most common melanoma site in women, and early detection at the in situ stage eliminates the risk of metastasis. Acral melanoma in situ on the foot or toes deserves particular attention due to its distinct biology and tendency for delayed diagnosis.
Documentation Requirements
- ✓Biopsy-confirmed melanoma in situ with right laterality and lower limb location specified.
- ✓Document the exact subsite (hip, thigh, knee, leg, ankle, foot, toe), histologic subtype, and surgical margin adequacy.
- ✓Include dermoscopic findings and surveillance schedule.