General Surgery Coding Alert

Location and type lead code choice.

Expect significant changes in how you report in situ breast cancers once ICD-10 goes into effect -- even if you'll have a little longer to prepare for the switch.

Don't forget: CMS has announced a proposed implementation delay from Oct. 1, 2013 for the new diagnosis code set, but the new implementation date is not yet finalized.

Look for Specific Type, Location in ICD-10

While ICD-9 provides just one code for in situ breast cancer (233.0, Carcinoma in situ of breast), you'll have 12 codes to choose from when ICD-10 goes into effect.

The new code set divides these cancers into four categories by "type": lobular, intraductal, other specified, and unspecified. You'll also need to designate whether the tumor is from the left, right, or unspecified breast.

Here are the ICD-10 crosswalk code choices for 233.0:

• D05.00 -- Lobular carcinoma in situ of unspecified breast
• D05.01 -- ... right breast
• D05.02 -- ... left breast
• D05.10 -- Intraductal carcinoma in situ of unspecified breast
• D05.11 -- ... right breast
• D05.12 -- ... left breast
• D05.80 -- Other specified type of carcinoma in situ of unspecified breast
• D05.81 -- ... right breast
• D05.82 -- ... left breast
• D05.90 -- Unspecified type of carcinoma in situ of unspecified breast
• D05.91 -- ... right breast
• D05.92 -- ... left breast.