D03.72 ICD-10-CM Code: Melanoma in situ of left lower limb, including hip
D03.72 maps to CMS-HCC V28 23. A source-labeled RAF reference is available. Confirm the documented diagnosis and applicable coding requirements. MEAT criteria · RAF Calculator · HCC Buddy coding tools
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FY 2026 Apr update / Neoplasms (C00-D49) / In situ neoplasms (D00-D09)
D03.72
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceMelanoma in situ of left lower limb, including hip
Early stage melanoma (cancer cells) found on the skin of the left leg or hip that has not yet invaded deeper layers of skin.
Buddy Insight
Melanoma in situ of the left lower limb including hip is an early melanocytic malignancy confined to the epidermis of the left leg, thigh, foot, or hip.
CMS-HCC V28
MappedHCC 23
Code-level coefficient reference
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
MappedHCC 013
Code-level coefficient reference
ESRD/PACE
MappedHCC 12
Code-level coefficient reference
RXHCC
MappedHCC 22
Code-level coefficient reference
Code Book Path
Inclusion Terms
OfficialNo inclusion terms are included in this display for D03.72. Check the code and parent instructions in the Code Book.
Excludes 2
OfficialNo Excludes 2 notes are included in this display for D03.72. Check the code and parent instructions in the Code Book.
Related Codes
Includes
Official- Bowen's diseaseInherited from D00-D09
- erythroplasiaInherited from D00-D09
- grade III intraepithelial neoplasiaInherited from D00-D09
- Queyrat's erythroplasiaInherited from D00-D09
Excludes 1
OfficialNo Excludes 1 notes are included in this display for D03.72. Check the code and parent instructions in the Code Book.
Code First
OfficialNo Code First sequencing instructions are included in this display for D03.72. Check the code and parent instructions in the Code Book.
Use Additional
OfficialNo Use Additional Code instructions are included in this display for D03.72. Check the code and parent instructions in the Code Book.
Code Also
OfficialNo Code Also instructions are included in this display for D03.72. Check the code and parent instructions in the Code Book.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
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 D03.72 an HCC code?
Yes. D03.72 (Melanoma in situ of left lower limb, including hip) maps to HCC 23, Prostate, Breast, and Other Cancers and Tumors under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 0.186. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes. It is billable for payment year 2026.
Coder answer: D03.72 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
- D03.72
- Description
- Melanoma in situ of left lower limb, including hip
- HCC (V28)
- HCC 23 — Prostate, Breast, and Other Cancers and Tumors
- RAF reference coefficient
- 0.186
- Billable
- Yes
- Payment year
- 2026
HCC Category Mapping
These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. 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 context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.
Work D03.72 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →
MEAT review for D03.72
For D03.72, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.
- 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
Coder workflow notes
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What This Code Means
D03.72 is the ICD-10-CM diagnosis code for melanoma in situ of left lower limb, including hip. Early stage melanoma (cancer cells) found on the skin of the left leg or hip that has not yet invaded deeper layers of skin. D03.72 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, D03.72 maps to Prostate, Breast, and Other Cancers and Tumors (HCC 23) with a source-labeled community, non-dual, aged reference coefficient of 0.186. No V24 mapping is shown for D03.72; use the applicable model and payment year when reviewing the V28 mapping. For CY2026 non-PACE Medicare Advantage, CMS uses 100% of the 2024 CMS-HCC model (V28). PACE uses a separate model blend. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes.
This code is for melanoma in situ only; if invasive melanoma is present, use codes from D43 series instead. For D03.72, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule. 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, source-labeled coefficient references, and MEAT documentation criteria for D03.72 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
- •Confirm left side documentation; if bilateral lesions exist, code each side separately
Clinical Significance
Melanoma in situ of the left lower limb including hip is an early melanocytic malignancy confined to the epidermis of the left leg, thigh, foot, or hip. Like all melanoma in situ, complete excision at this stage is curative. The lower extremity location is particularly common in women and in patients with chronic sun exposure to the legs.
Documentation Requirements
- ✓Biopsy-confirmed melanoma in situ with left laterality and lower limb location documented.
- ✓Include the specific subsite, histologic subtype, lesion dimensions, and excision margin status.
- ✓Follow-up documentation should address surveillance findings and any new pigmented lesions.