ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 D00.0

Non-Billable Header

Carcinoma in situ of lip, oral cavity and pharynx

D00
Block
0
Synonyms
0
LCDs
0
Payer Policies
0
Linked CPTs

About ICD-10-CM D00.0

ICD-10-CM code D00.0 represents Carcinoma in situ of lip, oral cavity and pharynx. This is a non-billable header code in the Neoplasms chapter (block D00). The 2026 edition of ICD-10-CM D00.0 became effective on October 1, 2025. Non-billable codes cannot be used as a primary or secondary diagnosis on a claim, use a more specific child code instead.

Type 1 Excludes

Pure excludes, these codes can never be coded together with D00.0. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • carcinoma in situ of aryepiglottic fold or interarytenoid fold, laryngeal aspect (D02.0)
  • carcinoma in situ of epiglottis NOS (D02.0)
  • carcinoma in situ of epiglottis suprahyoid portion (D02.0)
  • carcinoma in situ of skin of lip (D03.0, D04.0)

Use Additional Code

When coding D00.0, also report these additional codes when applicable.

  • code to identify:
  • exposure to environmental tobacco smoke (Z77.22)
  • exposure to tobacco smoke in the perinatal period (P96.81)
  • history of tobacco dependence (Z87.891)
  • occupational exposure to environmental tobacco smoke (Z57.31)
  • tobacco dependence (F17.-)
  • tobacco use (Z72.0)

Medicare LCD Coverage for D00.0

Local Coverage Determinations (LCDs) from CMS MACs that list D00.0 as a covered diagnosis.

No Medicare LCDs reference D00.0 as covered

This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.

Commercial Payer Coverage

Coverage policies from major commercial payers referencing D00.0.

No commercial payer policies reference D00.0 on file

Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but D00.0 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.

CPT Codes Commonly Billed with D00.0

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

No procedure linkages on file for D00.0

We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.

ICD-10 D00.0, Billing FAQ

Is ICD-10 code D00.0 billable? +

No, D00.0 is a non-billable header code. Use a more specific child code from block D00 when submitting claims.

What codes are Type 1 Excludes for D00.0? +

Type 1 Excludes (never code together with D00.0): carcinoma in situ of aryepiglottic fold or interarytenoid fold, laryngeal aspect (D02.0); carcinoma in situ of epiglottis NOS (D02.0); carcinoma in situ of epiglottis suprahyoid portion (D02.0)

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on June 1, 2026.

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