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

ICD-10 D01.3

Billable / Specific

Carcinoma in situ of anus and anal canal

D01
Block
2
Synonyms
464
LCDs
22
Payer Policies
27
Linked CPTs

About ICD-10-CM D01.3

ICD-10-CM code D01.3 represents Carcinoma in situ of anus and anal canal. This is a billable/specific code in the Neoplasms chapter (block D01). The 2026 edition of ICD-10-CM D01.3 became effective on October 1, 2025.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under D01.3. Per CMS ICD-10-CM Tabular 2026.

  • Anal intraepithelial neoplasia III [AIN III]
  • Severe dysplasia of anus

Type 1 Excludes

Pure excludes, these codes can never be coded together with D01.3. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • anal intraepithelial neoplasia I and II [AIN I and AIN II] (K62.82)
  • carcinoma in situ of anal margin (D04.5)
  • carcinoma in situ of anal skin (D04.5)
  • carcinoma in situ of perianal skin (D04.5)

Medicare LCD Coverage for D01.3

Local Coverage Determinations (LCDs) from CMS MACs that list D01.3 as a covered diagnosis.

464 LCDs

Showing top 10 of 464 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Transrectal Ultrasound
Article ID: 57427, Effective: 2024-10-01 00:00:00, 118 covered, 0 non-covered
CPT 76872 →
CMS LCD: Billing and Coding: Transrectal Ultrasound
Article ID: 57427, Effective: 2024-10-01 00:00:00, 118 covered, 0 non-covered
CPT 76873 →
CMS LCD: Billing and Coding: MolDX: Lab-Developed Tests for Inherited Cancer Syndromes in Patients with Cancer
Article ID: 58679, Effective: 2026-02-05 00:00:00, 1346 covered, 0 non-covered
CPT 81215 →
CMS LCD: Billing and Coding: MolDX: Lab-Developed Tests for Inherited Cancer Syndromes in Patients with Cancer
Article ID: 58679, Effective: 2026-02-05 00:00:00, 1346 covered, 0 non-covered
CPT 81300 →
CMS LCD: Billing and Coding: MolDX: Lab-Developed Tests for Inherited Cancer Syndromes in Patients with Cancer
Article ID: 58679, Effective: 2026-02-05 00:00:00, 1346 covered, 0 non-covered
CPT 81351 →
CMS LCD: Billing and Coding: MolDX: Lab-Developed Tests for Inherited Cancer Syndromes in Patients with Cancer
Article ID: 58679, Effective: 2026-02-05 00:00:00, 1346 covered, 0 non-covered
CPT 81167 →
CMS LCD: Billing and Coding: MolDX: Lab-Developed Tests for Inherited Cancer Syndromes in Patients with Cancer
Article ID: 58679, Effective: 2026-02-05 00:00:00, 1346 covered, 0 non-covered
CPT 81405 →
CMS LCD: Billing and Coding: MolDX: Lab-Developed Tests for Inherited Cancer Syndromes in Patients with Cancer
Article ID: 58679, Effective: 2026-02-05 00:00:00, 1346 covered, 0 non-covered
CPT 0103U →
CMS LCD: Billing and Coding: MolDX: Lab-Developed Tests for Inherited Cancer Syndromes in Patients with Cancer
Article ID: 58679, Effective: 2026-02-05 00:00:00, 1346 covered, 0 non-covered
CPT 81201 →
CMS LCD: Billing and Coding: MolDX: Lab-Developed Tests for Inherited Cancer Syndromes in Patients with Cancer
Article ID: 58679, Effective: 2026-02-05 00:00:00, 1346 covered, 0 non-covered
CPT 81297 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing D01.3.

22 policies

1 Aetna

Transrectal Ultrasound - Medical Clinical Policy Bulletins | Aetna
Policy ID: CPB-0001

1 Cigna

Nucleic Acid Pathogen Testing - (0530)
Policy ID: MM_0530

5 Medicare

Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) - Policy Article
Policy ID: ART-52480
Billing and Coding: Cardiac Blood Pool Imaging (Multiple Gated Acquisition Scanning- MUGA, Ventriculography) When Performed in Conjunction with Cardiotoxic Chemotherapy
Policy ID: ART-54768
Billing and Coding: Diagnostic Colonoscopy
Policy ID: ART-55937
Billing and Coding: Colonoscopy and Sigmoidoscopy-Diagnostic
Policy ID: ART-56394
Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
Policy ID: ART-56456

CPT Codes Commonly Billed with D01.3

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

27 linkages
  • 44408 CMS LCD: Billing and Coding: Diagnostic Colonoscopy CMS LCD
  • 45379 CMS LCD: Billing and Coding: Diagnostic Colonoscopy CMS LCD
  • 44406 CMS LCD: Billing and Coding: Diagnostic Colonoscopy CMS LCD
  • 45390 CMS LCD: Billing and Coding: Diagnostic Colonoscopy CMS LCD
  • 45392 CMS LCD: Billing and Coding: Diagnostic Colonoscopy CMS LCD
  • 44394 CMS LCD: Billing and Coding: Diagnostic Colonoscopy CMS LCD
  • 44402 CMS LCD: Billing and Coding: Diagnostic Colonoscopy CMS LCD
  • 44390 CMS LCD: Billing and Coding: Diagnostic Colonoscopy CMS LCD
  • 44405 CMS LCD: Billing and Coding: Diagnostic Colonoscopy CMS LCD
  • 44388 CMS LCD: Billing and Coding: Diagnostic Colonoscopy CMS LCD

Convert D01.3 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
D01.3 2305 10000
D01.3 2306 10000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 D01.3, Billing FAQ

Is ICD-10 code D01.3 billable? +

Yes, D01.3 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What other names or terms map to D01.3? +

ICD-10 D01.3 includes: Anal intraepithelial neoplasia III [AIN III]; Severe dysplasia of anus.

What codes are Type 1 Excludes for D01.3? +

Type 1 Excludes (never code together with D01.3): anal intraepithelial neoplasia I and II [AIN I and AIN II] (K62.82); carcinoma in situ of anal margin (D04.5); carcinoma in situ of anal skin (D04.5)

What CPT codes are commonly billed with D01.3? +

Procedures frequently paired with D01.3 include: 44408, 45379, 44406, 45390, 45392.

What ICD-9 codes does D01.3 map to? +

Per CMS GEMs, D01.3 maps to ICD-9 codes: 2305, 2306. Useful for legacy data review and historical claim analysis.

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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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