ICD-10 · PDGM grouping
D04 Carcinoma in situ of skin
All 21 codes in the D04 family, with the PDGM clinical group, comorbidity subgroup and primary-position rule CMS assigns, read from the CMS grouper crosswalk v07.2.26 and the CDC FY2027 code file.
Codes in family
21
Can lead a claim
15
Cannot lead a claim
6
What CMS assigns to D04
15 of the 21 codes group to MMTA - Infectious Disease, Neoplasms, and Blood-Forming Diseases; 6 are assigned no clinical group. None of the 21 is assigned a comorbidity subgroup. 15 of the 21 can lead a claim.
Every code in D04
Descriptions are CDC’s FY2027 wording; where CMS’s grouper abbreviates one, its form is shown beneath.
| Code | Description | Primary position | Clinical group | Comorbidity subgroup |
|---|---|---|---|---|
| D04.0 | Carcinoma in situ of skin of lip | Can lead a claim | K | None |
| D04.1 Carcinoma in situ of skin of eyelid, including canthus | ||||
| D04.10 | Carcinoma in situ of skin of unspecified eyelid, including canthusCMS: Carcinoma in situ of skin of unsp eyelid, including canthus | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| D04.11 Carcinoma in situ of skin of right eyelid, including canthus | ||||
| D04.111 | Carcinoma in situ of skin of right upper eyelid, including canthusCMS: Ca in situ skin of right upper eyelid, including canthus | Can lead a claim | K | None |
| D04.112 | Carcinoma in situ of skin of right lower eyelid, including canthusCMS: Ca in situ skin of right lower eyelid, including canthus | Can lead a claim | K | None |
| D04.12 Carcinoma in situ of skin of left eyelid, including canthus | ||||
| D04.121 | Carcinoma in situ of skin of left upper eyelid, including canthusCMS: Ca in situ skin of left upper eyelid, including canthus | Can lead a claim | K | None |
| D04.122 | Carcinoma in situ of skin of left lower eyelid, including canthusCMS: Ca in situ skin of left lower eyelid, including canthus | Can lead a claim | K | None |
| D04.2 Carcinoma in situ of skin of ear and external auricular canal | ||||
| D04.20 | Carcinoma in situ of skin of unspecified ear and external auricular canalCMS: Ca in situ skin of unsp ear and external auricular canal | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| D04.21 | Carcinoma in situ of skin of right ear and external auricular canalCMS: Ca in situ skin of right ear and external auricular canal | Can lead a claim | K | None |
| D04.22 | Carcinoma in situ of skin of left ear and external auricular canalCMS: Ca in situ skin of left ear and external auricular canal | Can lead a claim | K | None |
| D04.3 Carcinoma in situ of skin of other and unspecified parts of face | ||||
| D04.30 | Carcinoma in situ of skin of unspecified part of face | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| D04.39 | Carcinoma in situ of skin of other parts of face | Can lead a claim | K | None |
| D04.4 | Carcinoma in situ of skin of scalp and neck | Can lead a claim | K | None |
| D04.5 | Carcinoma in situ of skin of trunk | Can lead a claim | K | None |
| D04.6 Carcinoma in situ of skin of upper limb, including shoulder | ||||
| D04.60 | Carcinoma in situ of skin of unspecified upper limb, including shoulderCMS: Ca in situ skin of unsp upper limb, including shoulder | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| D04.61 | Carcinoma in situ of skin of right upper limb, including shoulderCMS: Ca in situ skin of right upper limb, including shoulder | Can lead a claim | K | None |
| D04.62 | Carcinoma in situ of skin of left upper limb, including shoulderCMS: Ca in situ skin of left upper limb, including shoulder | Can lead a claim | K | None |
| D04.7 Carcinoma in situ of skin of lower limb, including hip | ||||
| D04.70 | Carcinoma in situ of skin of unspecified lower limb, including hipCMS: Carcinoma in situ of skin of unsp lower limb, including hip | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| D04.71 | Carcinoma in situ of skin of right lower limb, including hip | Can lead a claim | K | None |
| D04.72 | Carcinoma in situ of skin of left lower limb, including hip | Can lead a claim | K | None |
| D04.8 | Carcinoma in situ of skin of other sites | Can lead a claim | K | None |
| D04.9 | Carcinoma in situ of skin, unspecified | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
Sources: CMS HH PPS Grouper Software v07.2.26, effective 2026-10-01, for the clinical group, comorbidity subgroup, code-first conventions and primary-position flags; CDC NCHS ICD-10-CM FY2027 code descriptions for the family title and code wording. This is the crosswalk Medicare runs a claim through. Grouping also depends on admission source, timing, the OASIS functional items and the rest of the diagnosis list.
The monthly home health regs digest
What CMS changed, what's due next, and what to do about it — one email a month, no fluff. Read the first issue