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D05.10 ICD-10-CM Code: Intraductal carcinoma in situ of unspecified breast

D05.10 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC Buddy coding tools

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Code lookupD05.10

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

D05.10

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

Intraductal carcinoma in situ of unspecified breast

Abnormal cells found inside the milk ducts of the breast that have not spread beyond the breast tissue, but the specific breast (left or right) is not documented.

CMS-HCC V28

N/A

Not mapped

CMS-HCC V24

Historical

Historical

Not used for CY2026 payment

ACA/HHS

N/A

Not mapped

ESRD/PACE

N/A

Not mapped

RXHCC

N/A

Not mapped

Inclusion Terms

Official

No inclusion terms are included in this display for D05.10. Check the code and parent instructions in the Code Book.

Excludes 2

Official
  • malignant neoplasm of breast (C50.-)Inherited from D05

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

Official
  • carcinoma in situ of skin of breast (D04.5)Inherited from D05
  • melanoma in situ of breast (skin) (D03.5)Inherited from D05
  • Paget's disease of breast or nipple (C50.-)Inherited from D05

Code First

Official

No Code First sequencing instructions are included in this display for D05.10. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for D05.10. Check the code and parent instructions in the Code Book.

Code Also

Official

No Code Also instructions are included in this display for D05.10. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance
This code should only be used when laterality cannot be determined from documentation; attempt to clarify with provider if possible
If documentation specifies right or left breast, use D05.11 or D05.12 instead

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 D05.10 an HCC code?

No. D05.10 is a billable ICD-10-CM code with no mapping under the current CMS-HCC V28 community payment model, and none under the ESRD, Part D RxHCC, or HHS-HCC models.

Code
D05.10
Description
Intraductal carcinoma in situ of unspecified breast
HCC (V28)
No CMS-HCC V28 mapping
RAF reference coefficient
Billable
Yes
Payment year
2026

Coder workflow notes

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What This Code Means

D05.10 is the ICD-10-CM diagnosis code for intraductal carcinoma in situ of unspecified breast. Abnormal cells found inside the milk ducts of the breast that have not spread beyond the breast tissue, but the specific breast (left or right) is not documented. D05.10 sits in the ICD-10-CM chapter for neoplasms (c00-d49), within the section covering in situ neoplasms (d00-d09).

D05.10 is a billable ICD-10-CM code, but no current CMS-HCC V28 community payment mapping is shown, and none under the ESRD, Part D RxHCC, or HHS-HCC models. Do not assign risk adjustment value from this page when no source-backed mapping is shown; verify the applicable model and payment year.

This code should only be used when laterality cannot be determined from documentation; attempt to clarify with provider if possible.

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

Coding Tips

  • This code should only be used when laterality cannot be determined from documentation; attempt to clarify with provider if possible
  • If documentation specifies right or left breast, use D05.11 or D05.12 instead

Child Codes

Code Hierarchy

Also searched as

  • D05 10
  • D0510

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