ICD-10 D03.8
Billable / Specific HCC v28: 12Melanoma in situ of other sites
About ICD-10-CM D03.8
ICD-10-CM code D03.8 represents Melanoma in situ of other sites. This is a billable/specific code in the Neoplasms chapter (block D03). The 2026 edition of ICD-10-CM D03.8 became effective on October 1, 2025.
Coding Tips for D03.8
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
D03.8 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 D03.8. Per CMS ICD-10-CM Tabular 2026.
- Melanoma in situ of scrotum
Type 1 Excludes
Pure excludes, these codes can never be coded together with D03.8. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- carcinoma in situ of scrotum (D07.61)
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 D03.8
Local Coverage Determinations (LCDs) from CMS MACs that list D03.8 as a covered diagnosis.
Showing top 10 of 1,158 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing D03.8.
5 Medicare
CPT Codes Commonly Billed with D03.8
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
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 D03.8 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 |
|---|---|---|
| D03.8 | 1728 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To D03.8
Other codes in section D00-D09 (In situ neoplasms).
ICD-10 D03.8, Billing FAQ
Is ICD-10 code D03.8 billable? +
Yes, D03.8 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 D03.8? +
ICD-10 D03.8 includes: Melanoma in situ of scrotum.
What codes are Type 1 Excludes for D03.8? +
Type 1 Excludes (never code together with D03.8): carcinoma in situ of scrotum (D07.61)
Does D03.8 affect Medicare Advantage HCC risk adjustment? +
Yes. D03.8 maps to CMS-HCC v28 category 12. Capture this diagnosis annually for accurate Medicare Advantage risk score.
What ICD-9 codes does D03.8 map to? +
Per CMS GEMs, D03.8 maps to ICD-9 codes: 1728. 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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