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D05 ICD-10-CM Code: Carcinoma in situ of breast

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)

D05

Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidance

Carcinoma in situ of breast

Carcinoma in situ of breast

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
D0In situ neoplasms (D00-D09)
D05Carcinoma in situ of breast

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for D05 in this effective period.

Excludes 2

Official
  • malignant neoplasm of breast (C50.-)

Related Child Codes

Official
D05.0Lobular carcinoma in situ of breast
D05.1Intraductal carcinoma in situ of breast
D05.8Other specified type of carcinoma in situ of breast
D05.9Unspecified type of carcinoma in situ of breast

Includes

Official

ICD-10-CM does not list Includes notes for D05 in this effective period.

Excludes 1

Official
  • carcinoma in situ of skin of breast (D04.5)
  • melanoma in situ of breast (skin) (D03.5)
  • Paget's disease of breast or nipple (C50.-)

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for D05 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for D05 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for D05 in this effective period.

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.

Coder workflow notes

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What This Code Means

D05 is the ICD-10-CM diagnosis code for carcinoma in situ of breast. D05 sits in the ICD-10-CM chapter for neoplasms (c00-d49), within the section covering in situ neoplasms (d00-d09).

Header codes like D05 cannot be reported on claims directly, they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at D05's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for D05 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Excludes 1, Do NOT code together

  • carcinoma in situ of skin of breast (D04.5)
  • melanoma in situ of breast (skin) (D03.5)
  • Paget's disease of breast or nipple (C50.-)

Excludes 2, Not included here, may code separately

  • malignant neoplasm of breast (C50.-)

Child Codes

Code Hierarchy

D05Carcinoma in situ of breast
D05Carcinoma in situ of breast

Work D05 in HCC Buddy

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