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

ICD-10 D05.91

Billable / Specific

Unspecified type of carcinoma in situ of right breast

D05
Block
0
Synonyms
1,111
LCDs
26
Payer Policies
3
Linked CPTs

About ICD-10-CM D05.91

ICD-10-CM code D05.91 represents Unspecified type of carcinoma in situ of right breast. This is a billable/specific code in the Neoplasms chapter (block D05). The 2026 edition of ICD-10-CM D05.91 became effective on October 1, 2025.

Medicare LCD Coverage for D05.91

Local Coverage Determinations (LCDs) from CMS MACs that list D05.91 as a covered diagnosis.

1,111 LCDs

Showing top 10 of 1,111 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: 58734, Effective: 2025-10-01 00:00:00, 268 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: 58734, Effective: 2025-10-01 00:00:00, 268 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: 58734, Effective: 2025-10-01 00:00:00, 268 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: 58734, Effective: 2025-10-01 00:00:00, 268 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: 58734, Effective: 2025-10-01 00:00:00, 268 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: 58734, Effective: 2025-10-01 00:00:00, 268 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: 58734, Effective: 2025-10-01 00:00:00, 268 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: 58734, Effective: 2025-10-01 00:00:00, 268 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: 58734, Effective: 2025-10-01 00:00:00, 268 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: 58734, Effective: 2025-10-01 00:00:00, 268 covered, 0 non-covered
CPT 81299 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing D05.91.

26 policies

5 Medicare

Billing and Coding: Denosumab (Prolia�, Xgeva�, Jubbonti�, Wyost�, Ospomyv�,Xbryk�,Bomyntra�, Conexxence�, Stoboclo�, Osenvelt�,Bildyos�, Bilprevda�)
Policy ID: ART-52399
External Breast Prostheses - Policy Article
Policy ID: ART-52478
Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) - Policy Article
Policy ID: ART-52480
Billing and Coding: Cardiac Blood Pool Imaging (Multiple Gated Acquisition Scanning- MUGA, Ventriculography) When Performed in Conjunction with Cardiotoxic Chemotherapy
Policy ID: ART-54768
Billing and Coding: Molecular Pathology Procedures
Policy ID: ART-56199

CPT Codes Commonly Billed with D05.91

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

3 linkages
  • J2430 CMS LCD: Billing and Coding: Bisphosphonate Drug Therapy CMS LCD
  • J1740 CMS LCD: Billing and Coding: Bisphosphonate Drug Therapy CMS LCD
  • J3489 CMS LCD: Billing and Coding: Bisphosphonate Drug Therapy CMS LCD

Convert D05.91 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
D05.91 2330 10000

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

ICD-10 D05.91, Billing FAQ

Is ICD-10 code D05.91 billable? +

Yes, D05.91 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What CPT codes are commonly billed with D05.91? +

Procedures frequently paired with D05.91 include: J2430, J1740, J3489.

What ICD-9 codes does D05.91 map to? +

Per CMS GEMs, D05.91 maps to ICD-9 codes: 2330. 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 July 16, 2026.

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