ICD-10 Coding for Mole on Nose Requiring Dermatology Referral
For a mole on the nose requiring dermatology referral, use ICD-10 code D22.39 (Other melanocytic nevi of other parts of face) for a benign-appearing nevus, or D48.5 (Neoplasm of uncertain behavior of skin) if there are concerning features warranting specialist evaluation.
Primary Diagnostic Codes
For Benign-Appearing Nevi
- D22.39: Other melanocytic nevi of other parts of face - this is the most appropriate code for a clinically benign mole on the nose 1
- D22.30: Melanocytic nevi of unspecified part of face can be used if documentation is less specific
For Suspicious or Atypical Lesions
- D48.5: Neoplasm of uncertain behavior of skin - use this when the lesion has atypical features requiring specialist assessment 2
- D23.39: Other benign neoplasm of skin of other parts of face - for confirmed benign lesions with specific characteristics
Clinical Features Justifying Referral
Major signs that mandate dermatology referral (any one present):
Minor signs that strengthen referral indication:
- Inflammation around the lesion 1, 2
- Sensory change (itching, increased awareness) 1, 2
- Crusting or bleeding 1, 2
Documentation Requirements for Referral
Your referral documentation should include:
- Explicit clinical suspicion: State "Suspected melanoma - urgent assessment requested" or "Atypical nevus requiring specialist evaluation" to ensure proper triage 2
- Precise anatomical location: Document as "Mole on dorsum of nose" or "Pigmented lesion on left nasal ala" 2
- Specific features present: Document which major and minor signs are present 1
- Duration and evolution: Include timeframe of any observed changes 2
Additional Coding Considerations
Risk Factor Documentation
If applicable, add secondary codes for:
- Z85.820: Personal history of malignant melanoma of skin
- Z80.8: Family history of malignant neoplasm of other organs and systems (if family history of melanoma) 1
- Z94.83: Organ transplant status (if immunosuppressed patient) 1
Reason for Encounter
- Z13.89: Encounter for screening for other disorder - if this is a screening examination
- R23.8: Other skin changes - if patient reports changes in the lesion
Critical Pitfalls to Avoid
Do not remove suspicious lesions in primary care - lesions suspicious for melanoma should not be excised outside of specialist care, as clinicopathological correlation is vital for diagnostic accuracy 1
Do not use diameter alone as exclusion criterion - approximately 38% of melanomas are ≤6mm in diameter, and many are <5mm 2
Do not perform shave or punch biopsies - these compromise accurate pathological staging and should not be done for suspected melanomas 1
Document even if uncertain - any pigmented lesion causing clinical concern warrants referral regardless of checklist criteria 1