D05.12 ICD-10-CM Code: Intraductal carcinoma in situ of left breast
D05.12 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · free HCC coding tools
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FY 2026 Apr update / Neoplasms (C00-D49) / In situ neoplasms (D00-D09)
D05.12
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceIntraductal carcinoma in situ of left breast
Abnormal cells found inside the milk ducts of the left breast that have not spread beyond the breast tissue; this is a pre-cancerous condition requiring monitoring and treatment.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialNo inclusion terms are included in this display for D05.12. Check the code and parent instructions in the Code Book.
Excludes 2
Official- malignant neoplasm of breast (C50.-)Inherited from D05
Related Codes
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
OfficialNo Code First sequencing instructions are included in this display for D05.12. Check the code and parent instructions in the Code Book.
Use Additional
OfficialNo Use Additional Code instructions are included in this display for D05.12. Check the code and parent instructions in the Code Book.
Code Also
OfficialNo Code Also instructions are included in this display for D05.12. Check the code and parent instructions in the Code Book.
Buddy Documentation Tip
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 D05.12 an HCC code?
No. D05.12 is a billable ICD-10-CM code with no mapping under the CMS-HCC V28 or V24 community payment models, and none under the ESRD, Part D RxHCC, or HHS-HCC models.
- Code
- D05.12
- Description
- Intraductal carcinoma in situ of left breast
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF reference coefficient
- —
- 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
D05.12 is the ICD-10-CM diagnosis code for intraductal carcinoma in situ of left breast. Abnormal cells found inside the milk ducts of the left breast that have not spread beyond the breast tissue; this is a pre-cancerous condition requiring monitoring and treatment. D05.12 sits in the ICD-10-CM chapter for neoplasms (c00-d49), within the section covering in situ neoplasms (d00-d09).
D05.12 is a billable ICD-10-CM code, but the current payload does not show a mapping under the CMS-HCC V28 or V24 community payment models, 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.
Verify that documentation specifically identifies the left breast to avoid coding errors with laterality.
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for D05.12 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify that documentation specifically identifies the left breast to avoid coding errors with laterality
- •Intraductal carcinoma in situ is also known as ductal carcinoma in situ (DCIS); both terms refer to the same condition