ICD-10 D03.122
Billable / Specific HCC v28: 12Melanoma in situ of left lower eyelid, including canthus
About ICD-10-CM D03.122
ICD-10-CM code D03.122 represents Melanoma in situ of left lower eyelid, including canthus. This is a billable/specific code in the Neoplasms chapter (block D03). The 2026 edition of ICD-10-CM D03.122 became effective on October 1, 2025.
Coding Tips for D03.122
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
D03.122 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
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 D03.122
Local Coverage Determinations (LCDs) from CMS MACs that list D03.122 as a covered diagnosis.
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Commercial Payer Coverage
Coverage policies from major commercial payers referencing D03.122.
5 Medicare
CPT Codes Commonly Billed with D03.122
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
Codes Adjacent To D03.122
Other codes in section D00-D09 (In situ neoplasms).
ICD-10 D03.122, Billing FAQ
Is ICD-10 code D03.122 billable? +
Yes, D03.122 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
Does D03.122 affect Medicare Advantage HCC risk adjustment? +
Yes. D03.122 maps to CMS-HCC v28 category 12. Capture this diagnosis annually for accurate Medicare Advantage risk score.
What CPT codes are commonly billed with D03.122? +
Procedures frequently paired with D03.122 include: 81210, 67912.
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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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