ICD-10 D05
Non-Billable HeaderCarcinoma in situ of breast
About ICD-10-CM D05
ICD-10-CM code D05 represents Carcinoma in situ of breast. This is a non-billable header code in the Neoplasms chapter (block D05). The 2026 edition of ICD-10-CM D05 became effective on October 1, 2025. Non-billable codes cannot be used as a primary or secondary diagnosis on a claim, use a more specific child code instead.
Type 1 Excludes
Pure excludes, these codes can never be coded together with D05. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- carcinoma in situ of skin of breast (D04.5)
- melanoma in situ of breast (skin) (D03.5)
- Paget's disease of breast or nipple (C50.-)
Type 2 Excludes
Not included here, the excluded code is not part of D05, but a patient may have both conditions at the same time. Both codes may be coded together when applicable.
- malignant neoplasm of breast (C50.-)
Medicare LCD Coverage for D05
Local Coverage Determinations (LCDs) from CMS MACs that list D05 as a covered diagnosis.
This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing D05.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but D05 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with D05
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.
Codes Adjacent To D05
Other codes in section D00-D09 (In situ neoplasms).
ICD-10 D05, Billing FAQ
Is ICD-10 code D05 billable? +
No, D05 is a non-billable header code. Use a more specific child code from block D05 when submitting claims.
What codes are Type 1 Excludes for D05? +
Type 1 Excludes (never code together with D05): carcinoma in situ of skin of breast (D04.5); melanoma in situ of breast (skin) (D03.5); Paget's disease of breast or nipple (C50.-)
What codes are Type 2 Excludes for D05? +
Type 2 Excludes (may be coded together when both conditions exist): malignant neoplasm of breast (C50.-)
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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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