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D03.9 ICD-10-CM Code: Melanoma in situ, unspecified

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Coding at a Glance

Tabular directives
4 inclusion terms
Risk adjustment
CMS-HCC V28: 1 category · CMS-HCC V22 category 12 · RxHCC V08 category 22

Inpatient Payment Groups (MS-DRG)

Potential MS-DRG participation — not a DRG assignment.

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v44, Appendix B.

  • MS-DRG 595 — MAJOR SKIN DISORDERS WITH MCC (MDC 09)
  • MS-DRG 596 — MAJOR SKIN DISORDERS WITHOUT MCC (MDC 09)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Risk Adjustment (CMS-HCC)

Payment categories this diagnosis maps to under CMS-HCC V28, payment year 2026.

  • HCC 23 — Prostate, Breast, and Other Cancers and Tumors

Other models: CMS-HCC V22 HCC 12 · RxHCC V08 HCC 22

Risk scores depend on the enrollee's full accepted diagnosis set and segment; a category mapping alone does not determine payment.

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for D03.9 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2027Effective: October 1, 2026

Trace:FY2027 changesChange historyRelease, file and checksum

Notes without a marker are published on D03.9 itself; “inherited from” names the category or block whose note applies here.

Includes

Conditions the official ICD-10-CM tabular list includes under this code.

  • Bowen's disease
  • erythroplasia
  • grade III intraepithelial neoplasia
  • Queyrat's erythroplasia

Source: inherited from D00-D09

Coder workflow for D03.9

MedCoder structured workflow — derived from this code’s own official record

Before you code D03.9

  1. Unspecified does not mean incorrect. When the record gives no greater specificity, D03.9 may be the appropriate code. Check the record for detail that supports a more specific sibling. An unspecified code is for records that do not provide the detail a more specific code needs; a query, not an assumption, is the route to specificity (Guidelines I.A.9.b, I.B.18).

    ReviewD03.0, D03.1, D03.2, D03.4, D03.5, D03.6, D03.7, D03.8

    See the relationships section · Guide: Other vs unspecified (NEC vs NOS) →

  2. Confirm the documented site and behavior (this code’s block classifies in situ neoplasms), whether the site is primary or secondary, and whether the malignancy is current or a personal history: a previously excised malignancy with no further treatment and no evidence of disease is history, not current disease. Verify the site against the Table of Neoplasms. Neoplasm chapter guidelines (Guidelines I.C.2.a, I.C.2.d, I.C.2.m).

    See the Table of Neoplasms entries · Guide: Active cancer vs history of cancer →

Choose the right path

  1. Does the record document the detail a more specific sibling code needs?
    Yes → Review the specific siblings in this subcategory.
    No → Continue — D03.9 is appropriate when the documentation goes no further.

    ReviewD03.0, D03.1, D03.2, D03.4, D03.5, D03.6, D03.7, D03.8

Consider D03.9. Then confirm the code is valid for the date of service in the Verify section.

Documentation check

The provider’s diagnostic statement
Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
Anatomical site
At the most specific level the record states; a site the classification separates cannot be assumed from a procedure or a measurement.
Behavior and current-versus-history status
Malignant, in situ, benign or uncertain; primary or secondary; current disease or personal history (Guidelines I.C.2.m).
Any detail beyond this code’s title
What the record states that a more specific sibling code would capture — or its absence, which itself supports the unspecified code.

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Documentation: The provider documents the condition in the terms of this code’s title and records no further detail.

Coding question: Is a more specific sibling code supportable?

Path: Review the specific siblings in this subcategory and what each requires the record to state.

Reason: A more specific code needs documentation of the distinguishing element; without it the unspecified code is appropriate, and a provider query is the route to specificity (Guidelines I.A.9.b, I.B.18).

ReviewD03.0, D03.1, D03.2, D03.4, D03.5, D03.6, D03.7, D03.8

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Code Overview

Melanoma in situ, unspecified is a billable ICD-10-CM diagnosis code (D03.9).

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Indexed Clinical Terms (2)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

Verify Before Coding

  • No Medicare Code Editor or MS-DRG Definitions Manual restrictions apply to this code.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder structured relationships — computed from published CMS and AHRQ datasets

Other codes that name D03.9 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 6 Excludes1 notes: C43 — Malignant melanoma of skin (via D03.-), D00 — Carcinoma in situ of oral cavity, esophagus and stomach (via D03.-), D01 — Carcinoma in situ of other and unspecified digestive organs (via D03.-), D02 — Carcinoma in situ of middle ear and respiratory system (via D03.-), D04 — Carcinoma in situ of skin (via D03.-), D09 — Carcinoma in situ of other and unspecified sites (via D03.-).

These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.

MS-DRG Grouper Relationships (FY2027)

Potential MS-DRG participation — not a DRG assignment.

FY2027 MS-DRG: not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity for that release.

Named in the grouper logic of 2 MS-DRGs: DRG 595 (MDC 09), DRG 596 (MDC 09).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):NEO025 — Skin cancers - melanoma (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same CMS-HCC risk category (V28)

CMS maps these diagnoses to the same Hierarchical Condition Category (Prostate, Breast, and Other Cancers and Tumors) for risk-adjusted payment.

D03.51 — Melanoma in situ of anal skin, D03.52 — Melanoma in situ of breast (skin) (soft tissue), D03.59 — Melanoma in situ of other part of trunk, D03.60 — Melanoma in situ of unspecified upper limb, including shoulder, D03.61 — Melanoma in situ of right upper limb, including shoulder, D03.62 — Melanoma in situ of left upper limb, including shoulder, D03.70 — Melanoma in situ of unspecified lower limb, including hip, D03.71 — Melanoma in situ of right lower limb, including hip, D03.72 — Melanoma in situ of left lower limb, including hip, D03.8 — Melanoma in situ of other sites, D18.02 — Hemangioma of intracranial structures, D32.0 — Benign neoplasm of cerebral meninges, D32.1 — Benign neoplasm of spinal meninges, D32.9 — Benign neoplasm of meninges, unspecified, D33.0 — Benign neoplasm of brain, supratentorial, D33.1 — Benign neoplasm of brain, infratentorial, D33.2 — Benign neoplasm of brain, unspecified, D33.3 — Benign neoplasm of cranial nerves, D33.4 — Benign neoplasm of spinal cord, D33.7 — Benign neoplasm of other specified parts of central nervous system, +213 more

Related risk categories

These categories interact through CMS's HCC hierarchy — one can suppress the other's risk-adjustment weight when both are present on a claim.

Cancer Metastatic to Lung, Liver, Brain, and Other Organs; Acute Myeloid Leukemia Except Promyelocytic, Cancer Metastatic to Bone, Other and Unspecified Metastatic Cancer; Acute Leukemia Except Myeloid, Myelodysplastic Syndromes, Multiple Myeloma, and Other Cancers, Lung and Other Severe Cancers, Lymphoma and Other Cancers, Bladder, Colorectal, and Other Cancers

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Skin cancers - melanoma).

D03.112 — Melanoma in situ of right lower eyelid, including canthus, D03.12 — Melanoma in situ of left eyelid, including canthus, D03.121 — Melanoma in situ of left upper eyelid, including canthus, D03.122 — Melanoma in situ of left lower eyelid, including canthus, D03.20 — Melanoma in situ of unspecified ear and external auricular canal, D03.21 — Melanoma in situ of right ear and external auricular canal, D03.22 — Melanoma in situ of left ear and external auricular canal, D03.30 — Melanoma in situ of unspecified part of face, D03.39 — Melanoma in situ of other parts of face, D03.4 — Melanoma in situ of scalp and neck, D03.51 — Melanoma in situ of anal skin, D03.52 — Melanoma in situ of breast (skin) (soft tissue), D03.59 — Melanoma in situ of other part of trunk, D03.60 — Melanoma in situ of unspecified upper limb, including shoulder, D03.61 — Melanoma in situ of right upper limb, including shoulder, D03.62 — Melanoma in situ of left upper limb, including shoulder, D03.70 — Melanoma in situ of unspecified lower limb, including hip, D03.71 — Melanoma in situ of right lower limb, including hip, D03.72 — Melanoma in situ of left lower limb, including hip, D03.8 — Melanoma in situ of other sites, +30 more

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main term “Melanoma”; these codes share that main term but sit in a different category of the Tabular List.

C43.4 — Malignant melanoma of scalp and neck (skin, neck), C43.51 — Malignant melanoma of anal skin (skin, perineum), C43.52 — Malignant melanoma of skin of breast (skin, breast), C43.59 — Malignant melanoma of other part of trunk (skin, back), C43.6 — Malignant melanoma of upper limb, including shoulder (skin, arm), C43.7 — Malignant melanoma of lower limb, including hip (skin, toe), C43.8 — Malignant melanoma of overlapping sites of skin (skin, overlapping site), C43.9 — Malignant melanoma of skin, unspecified, C51.0 — Malignant neoplasm of labium majus (skin, labium, majus), C51.1 — Malignant neoplasm of labium minus (skin, labium, minus), C51.8 — Malignant neoplasm of overlapping sites of vulva (skin, vulva, overlapping sites), C51.9 — Malignant neoplasm of vulva, unspecified (skin, vulva), C60.0 — Malignant neoplasm of prepuce (skin, prepuce), C60.9 — Malignant neoplasm of penis, unspecified (skin, penis), C63.2 — Malignant neoplasm of scrotum (skin, scrotum), C63.9 — Malignant neoplasm of male genital organ, unspecified (skin, male genital organ NEC), C69.4 — Malignant neoplasm of ciliary body (spindle cell, type B), C79.81 — Secondary malignant neoplasm of breast (metastatic, breast), C79.82 — Secondary malignant neoplasm of genital organs (metastatic, genital organ), C79.89 — Secondary malignant neoplasm of other specified sites (metastatic, specified site NEC), +6 more

Lab tests where this diagnosis supports Medicare coverage (NCD)

Medicare's National Coverage Determination (NCD) program lists this diagnosis as medical justification for these lab tests.

Gamma-glutamyl Transferase (GGT) Test, Iron Panel

Contextual Map

Every relationship of D03.9 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run D03.9 with these 6 related codes in Claim Check

Hierarchy

Referenced by Excludes1 notes

Clinical classification (CCSR)

Risk adjustment (CMS-HCC)

  • HCC 23 — Prostate, Breast, and Other Cancers and Tumors [CMS-HCC]— CMS-HCC V28 · 2026

MS-DRG Grouper

MDC crossing

  • MDC 09 — Diseases and Disorders of the Skin, Subcutaneous Tissue and Breast[MDC crossing]: “Diseases and Disorders of the Skin, Subcutaneous Tissue and Breast — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 7,378 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2027

Index entries

  • Melanoma (malignant), in situ[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Melanoma (malignant), in situ, nail[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027

Nearest codes (31)

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data
CMS/CDC ICD-10-CM FY2027 tabular list, index and tables, effective October 1, 2026 Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v44.0 (October 2026) Release, file and checksum · Publisher’s page
Inpatient payment groups Official source data
CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v44 Release, file and checksum · Publisher’s page
Risk adjustment Official source data
2026 Mid-Year Final ICD-10 Mappings + Model Software (cms.gov/files/zip/2026-midyear-final-icd-10-mappings.zip, 2026-midyear-final-model-software.zip) — CMS-HCC V28, PY2026 mid-year final release Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data
CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder structured relationship
Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder explanation
Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "D03.9 — Melanoma in situ, unspecified." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/d03.9-melanoma-in-situ-unspecified

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Melanoma in situ, unspecified

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027, and none are recorded for this code. Note changes are tracked from FY2027 only.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to D03.9 in its code family, with their registry titles.

View all codes in the D03 family