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

ICD-10 D03.10

Billable / Specific HCC v28: 12

Melanoma in situ of unspecified eyelid, including canthus

D03
Block
0
Synonyms
799
LCDs
14
Payer Policies
0
Linked CPTs

About ICD-10-CM D03.10

ICD-10-CM code D03.10 represents Melanoma in situ of unspecified eyelid, including canthus. This is a billable/specific code in the Neoplasms chapter (block D03). The 2026 edition of ICD-10-CM D03.10 became effective on October 1, 2025.

Coding Tips for D03.10

Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.

HCC capture: document with MEAT each year

D03.10 is a CMS-HCC v28 risk-adjustment code (category 12). To count for the patient Risk Adjustment Factor (RAF), document the diagnosis with MEAT language each calendar year: Monitored, Evaluated, Assessed, Treated. A diagnosis on the problem list alone does not satisfy CMS RADV audit standards. Include the diagnosis in the assessment with current status and current treatment plan.

Medicare Advantage HCC Impact

CMS-HCC v28 (current)
Category 12
ESRD-HCC
Category 12
RxHCC (Part D)
Category 12

Capture this diagnosis annually for accurate risk adjustment. Missed HCC captures are the #1 revenue leak in Medicare Advantage risk programs.

Medicare LCD Coverage for D03.10

Local Coverage Determinations (LCDs) from CMS MACs that list D03.10 as a covered diagnosis.

799 LCDs

Showing top 10 of 799 total . Click a CPT for full coverage scope.

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 →
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 81298 →
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 81299 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing D03.10.

14 policies

5 Medicare

Billing and Coding: Paclitaxel (e.g., Taxol�/Abraxane �)
Policy ID: ART-52450
Oral Anticancer Drugs - Policy Article
Policy ID: ART-52479
Billing and Coding: Biomarkers for Oncology
Policy ID: ART-52986
Billing and Coding: Molecular Pathology Procedures
Policy ID: ART-56199
Billing and Coding: Mohs Micrographic Surgery
Policy ID: ART-56514

CPT Codes Commonly Billed with D03.10

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

No procedure linkages on file for D03.10

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.

Convert D03.10 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
D03.10 1721 10000

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

ICD-10 D03.10, Billing FAQ

Is ICD-10 code D03.10 billable? +

Yes, D03.10 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

Does D03.10 affect Medicare Advantage HCC risk adjustment? +

Yes. D03.10 maps to CMS-HCC v28 category 12. Capture this diagnosis annually for accurate Medicare Advantage risk score.

What ICD-9 codes does D03.10 map to? +

Per CMS GEMs, D03.10 maps to ICD-9 codes: 1721. 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 May 31, 2026.

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