Pathology/Lab Coding Alert

Question: If the pathology report indicates “ductal carcinoma in situ,” I’m uncertain what diagnosis code I should use. We used to report this as a generic “in situ breast cancer,” but I can’t find a code for that in ICD-10.  

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Answer: The correct ICD-10 code for breast ductal carcinoma in situ (DCIS) is one of the following, depending on the site of the lesion:

• D05.10 — Intraductal carcinoma in situ of unspecified breast
• D05.11 — Intraductal carcinoma in situ of right breast
• D05.12 — Intraductal carcinoma in situ of left breast.

As you recall, you did not have specific codes for DCIS under ICD-9, but had to use a single code (233.0, Carcinoma in situ of breast) for any in situ carcinoma of breast, including other forms such as lobular carcinoma in situ.

History is different: If the report indicates that the patient has a history of DCIS, but doesn’t provide that same diagnosis for a current specimen, you should report Z86.000 (Personal history of in-situ neoplasm of breast).