D04.4 ICD-10-CM Code: Carcinoma in situ of skin of scalp and neck
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)
D04.4
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceCarcinoma in situ of skin of scalp and neck
This code describes an early stage skin cancer (carcinoma in situ) found on the scalp or neck area where abnormal cells are present but have not yet spread to deeper layers of skin or other parts of the body. It represents a precancerous condition that requires treatment to prevent progression to invasive cancer.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
N/A—
Not mapped
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for D04.4 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for D04.4 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for D04.4 in this effective period.
Excludes 1
Official- erythroplasia of Queyrat (penis) NOS (D07.4)
- melanoma in situ (D03.-)
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for D04.4 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for D04.4 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for D04.4 in this effective period.
Buddy Documentation Tip
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 D04.4 an HCC code?
No. D04.4 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
- Code
- D04.4
- Description
- Carcinoma in situ of skin of scalp and neck
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF
- —
- Billable
- Yes
- Payment year
- 2026
Coder workflow notes
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This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
D04.4 is the ICD-10-CM diagnosis code for carcinoma in situ of skin of scalp and neck. This code describes an early stage skin cancer (carcinoma in situ) found on the scalp or neck area where abnormal cells are present but have not yet spread to deeper layers of skin or other parts of the body. It represents a precancerous condition that requires treatment to prevent progression to invasive cancer. D04.4 sits in the ICD-10-CM chapter for neoplasms (c00-d49), within the section covering in situ neoplasms (d00-d09).
D04.4 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.
Verify the specific anatomical location (scalp versus neck) in the documentation, as this affects code selection and may require additional specificity codes.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for D04.4 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify the specific anatomical location (scalp versus neck) in the documentation, as this affects code selection and may require additional specificity codes
- •Ensure the diagnosis explicitly states 'carcinoma in situ' rather than other skin conditions like actinic keratosis or melanoma in situ, which have different codes