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D05.80 ICD-10-CM Code: Other specified type of carcinoma in situ of unspecified breast

D05.80 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC coding software

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Code lookupD05.80

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

D05.80

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

Other specified type of carcinoma in situ of unspecified breast

Other types of pre-cancerous breast cell abnormalities 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 D05.80. 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 D05.80. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for D05.80. Check the code and parent instructions in the Code Book.

Code Also

Official

No Code Also instructions are included in this display for D05.80. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance
Use this code only when the type of carcinoma in situ is specified but does not fit into lobular or intraductal categories
Always attempt to determine laterality and use D05.81 or D05.82 if possible

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 D05.80 an HCC code?

No. D05.80 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
D05.80
Description
Other specified type of 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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This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).

What This Code Means

D05.80 is the ICD-10-CM diagnosis code for other specified type of carcinoma in situ of unspecified breast. Other types of pre-cancerous breast cell abnormalities that have not spread beyond the breast tissue, but the specific breast (left or right) is not documented. D05.80 sits in the ICD-10-CM chapter for neoplasms (c00-d49), within the section covering in situ neoplasms (d00-d09).

D05.80 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.

Use this code only when the type of carcinoma in situ is specified but does not fit into lobular or intraductal categories.

HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for D05.80 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Use this code only when the type of carcinoma in situ is specified but does not fit into lobular or intraductal categories
  • Always attempt to determine laterality and use D05.81 or D05.82 if possible

Child Codes

Code Hierarchy

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