ICD-10 D03.51
Billable / Specific HCC v28: 12Melanoma in situ of anal skin
About ICD-10-CM D03.51
ICD-10-CM code D03.51 represents Melanoma in situ of anal skin. This is a billable/specific code in the Neoplasms chapter (block D03). The 2026 edition of ICD-10-CM D03.51 became effective on October 1, 2025.
Coding Tips for D03.51
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
D03.51 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.
Inclusion Terms / Approximate Synonyms
Clinical terms and conditions classified under D03.51. Per CMS ICD-10-CM Tabular 2026.
- Melanoma in situ of anal margin
- Melanoma in situ of perianal skin
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 D03.51
Local Coverage Determinations (LCDs) from CMS MACs that list D03.51 as a covered diagnosis.
Showing top 10 of 1,034 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing D03.51.
5 Medicare
CPT Codes Commonly Billed with D03.51
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 81210 CMS LCD: Billing and Coding: MolDX: FDA-Approved BRAF Tests CMS LCD
Convert D03.51 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| D03.51 | 1725 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To D03.51
Other codes in section D00-D09 (In situ neoplasms).
ICD-10 D03.51, Billing FAQ
Is ICD-10 code D03.51 billable? +
Yes, D03.51 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 D03.51? +
ICD-10 D03.51 includes: Melanoma in situ of anal margin; Melanoma in situ of perianal skin.
Does D03.51 affect Medicare Advantage HCC risk adjustment? +
Yes. D03.51 maps to CMS-HCC v28 category 12. Capture this diagnosis annually for accurate Medicare Advantage risk score.
What CPT codes are commonly billed with D03.51? +
Procedures frequently paired with D03.51 include: 81210.
What ICD-9 codes does D03.51 map to? +
Per CMS GEMs, D03.51 maps to ICD-9 codes: 1725. 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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