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D04.9 ICD-10-CM Code: Carcinoma in situ of skin, unspecified

ICD-10-CM Code View

HCC Buddy Code Card

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

D04.9

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

Carcinoma in situ of skin, unspecified

Abnormal skin cells with the potential to become cancer but have not yet invaded deeper layers of skin, when the specific body location is not documented or specified.

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

Official
D04Carcinoma in situ of skin
D04.9Carcinoma in situ of skin, unspecified

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for D04.9 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for D04.9 in this effective period.

Related Child Codes

Official
D04.0Carcinoma in situ of skin of lip
D04.1Carcinoma in situ of skin of eyelid, including canthus
D04.2Carcinoma in situ of skin of ear and external auricular canal
D04.3Carcinoma in situ of skin of other and unspecified parts of face
D04.4Carcinoma in situ of skin of scalp and neck

Includes

Official

ICD-10-CM does not list Includes notes for D04.9 in this effective period.

Excludes 1

Official
  • erythroplasia of Queyrat (penis) NOS (D07.4)
  • melanoma in situ (D03.-)

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for D04.9 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for D04.9 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for D04.9 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
This is the least specific code in the D04 category; always attempt to identify and document the anatomical site
Use only when the location of the carcinoma in situ cannot be determined from the medical record

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 D04.9 an HCC code?

No. D04.9 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.

Code
D04.9
Description
Carcinoma in situ of skin, unspecified
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

D04.9 is the ICD-10-CM diagnosis code for carcinoma in situ of skin, unspecified. Abnormal skin cells with the potential to become cancer but have not yet invaded deeper layers of skin, when the specific body location is not documented or specified. D04.9 sits in the ICD-10-CM chapter for neoplasms (c00-d49), within the section covering in situ neoplasms (d00-d09).

D04.9 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.

This is the least specific code in the D04 category; always attempt to identify and document the anatomical site.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for D04.9 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • This is the least specific code in the D04 category; always attempt to identify and document the anatomical site
  • Use only when the location of the carcinoma in situ cannot be determined from the medical record

Child Codes

Code Hierarchy

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