D04.5 ICD-10-CM Code: Carcinoma in situ of skin of trunk
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FY 2026 Apr update / Neoplasms (C00-D49) / In situ neoplasms (D00-D09)
D04.5
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceCarcinoma in situ of skin of trunk
This code describes an early stage of skin cancer on the trunk (chest, back, abdomen, or sides) where abnormal cells are present but have not yet spread to deeper layers or other parts of the body. It represents a precancerous condition that requires treatment to prevent progression to invasive cancer.
CMS-HCC V28
00
RAF 0
CMS-HCC V24
00
RAF 0
ACA/HHS
00
RAF 0
ESRD/PACE
00
RAF 0
RXHCC
00
RAF 0
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Inclusion Terms
Official- Carcinoma in situ of anal margin
- Carcinoma in situ of anal skin
- Carcinoma in situ of perianal skin
- Carcinoma in situ of skin of breast
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for D04.5 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for D04.5 in this effective period.
Excludes 1
Official- carcinoma in situ of anus NOS (D01.3)
- carcinoma in situ of scrotum (D07.61)
- carcinoma in situ of skin of genital organs (D07.-)
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for D04.5 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for D04.5 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for D04.5 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 D04.5 an HCC code?
No. D04.5 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
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
D04.5 is the ICD-10-CM diagnosis code for carcinoma in situ of skin of trunk. This code describes an early stage of skin cancer on the trunk (chest, back, abdomen, or sides) where abnormal cells are present but have not yet spread to deeper layers or other parts of the body. It represents a precancerous condition that requires treatment to prevent progression to invasive cancer. D04.5 sits in the ICD-10-CM chapter for neoplasms (c00-d49), within the section covering in situ neoplasms (d00-d09).
D04.5 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.
Carcinoma in situ is considered a malignant neoplasm in ICD-10-CM, so code D04.5 should be reported as a primary diagnosis when this is the confirmed diagnosis.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for D04.5 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Carcinoma in situ is considered a malignant neoplasm in ICD-10-CM, so code D04.5 should be reported as a primary diagnosis when this is the confirmed diagnosis
- •Specify the exact location on the trunk when documentation is available (e.g., chest wall, back, abdomen) to ensure accurate coding, and verify whether this is a new diagnosis or follow-up care to determine if additional codes for history or status are needed