D05.92: Unspecified type of carcinoma in situ of left breast
D05.92, unspecified type of carcinoma in situ of left breast, is listed as a covered diagnosis in 13 Medicare billing and coding articles that apply to 93 HCPCS Level II codes, including L8035 (Custom breast prosthesis, post mastectomy, molded to…), L8002 (Breast prosthesis, mastectomy bra, with integrated breast…), L8001 (Breast prosthesis, mastectomy bra, with integrated breast…). 10 of these codes have a 2026 DMEPOS fee schedule amount; L8035 pays $4,403.11 to $5,283.69 depending on the state. The articles come from 4 Medicare contractors. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.
HCPCS Level II codes with D05.92 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| L8035 | Custom breast prosthesis, post mastectomy, molded to patient model, any type | Special coverage instructions apply | $4,403.11–$5,283.69 | 1 |
| L8002 | Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, bilateral, any size, any type | Special coverage instructions apply | $198.27–$218.12 | 1 |
| L8001 | Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type | Special coverage instructions apply | $150.77–$165.83 | 1 |
| L8015 | External breast prosthesis garment, with mastectomy form, post mastectomy | Special coverage instructions apply | $72.05–$86.41 | 1 |
| L8000 | Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type | Special coverage instructions apply | $44.70–$78.16 | 1 |
| A4280 | Adhesive skin support attachment for use with external breast prosthesis, each | Carrier judgment | $7.38–$8.13 | 1 |
| Q2028 | Injection, sculptra, 0.5 mg | Special coverage instructions apply | — | 2 |
| G0429 | Dermal filler injection(s) for the treatment of facial lipodystrophy syndrome (lds) (e.g., as a result of highly active antiretroviral therapy) | Carrier judgment | — | 2 |
| Q2026 | Injection, radiesse, 0.1 ml | Special coverage instructions apply | — | 2 |
| G0279 | Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) | Carrier judgment | — | 1 |
| C8903 | Magnetic resonance imaging with contrast, breast; unilateral | Special coverage instructions apply | — | 1 |
| C8905 | Magnetic resonance imaging without contrast followed by with contrast, breast; unilateral | Special coverage instructions apply | — | 1 |
| C8906 | Magnetic resonance imaging with contrast, breast; bilateral | Special coverage instructions apply | — | 1 |
| C8908 | Magnetic resonance imaging without contrast followed by with contrast, breast; bilateral | Special coverage instructions apply | — | 1 |
| J9217 | Leuprolide acetate (for depot suspension), 7.5 mg | Special coverage instructions apply | — | 1 |
| J1952 | Leuprolide injectable, camcevi, 1 mg | Carrier judgment | — | 1 |
| J3315 | Injection, triptorelin pamoate, 3.75 mg | Special coverage instructions apply | — | 1 |
| J1954 | Injection, leuprolide acetate for depot suspension (lutrate depot), 7.5 mg | Carrier judgment | — | 1 |
| J9202 | Goserelin acetate implant, per 3.6 mg | Special coverage instructions apply | — | 1 |
| J1950 | Injection, leuprolide acetate (for depot suspension), per 3.75 mg | Special coverage instructions apply | — | 1 |
| J9219 | Leuprolide acetate implant, 65 mg | Special coverage instructions apply | — | 1 |
| J9225 | Histrelin implant (vantas), 50 mg | Special coverage instructions apply | — | 1 |
| J3489 | Injection, zoledronic acid, 1 mg | Carrier judgment | — | 1 |
| J1740 | Injection, ibandronate sodium, 1 mg | Carrier judgment | — | 1 |
| J2430 | Injection, pamidronate disodium, per 30 mg | Special coverage instructions apply | — | 1 |
68 more codes are listed. See every code with payment by region in Caduvo.
Medicare policy articles listing D05.92
- A52478: External Breast Prostheses - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC); 6 Level II codes). LCD with the same title: L33317
- A56448: Billing and Coding: Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 5 Level II codes). LCD with the same title: L33950
- A59160: Billing and Coding: Luteinizing Hormone-Releasing Hormone (LHRH) Analogs (Palmetto GBA (MAC - Part A, MAC - Part B); 8 Level II codes). LCD with the same title: L39387
- A59299: Billing and Coding: Cosmetic and Reconstructive Surgery (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 3 Level II codes). LCD with the same title: L33428, L35090, L38914, L39051
- A58774: Billing and Coding: Cosmetic and Reconstructive Surgery (WPS Insurance Corporation (MAC - Part A, MAC - Part B); 3 Level II codes). LCD with the same title: L33428, L35090, L38914, L39051
- A56907: Billing and Coding: Bisphosphonate Drug Therapy (WPS Insurance Corporation (MAC - Part A, MAC - Part B); 3 Level II codes). LCD with the same title: L34648
- A52399: Billing and Coding: Denosumab (Prolia®, Xgeva®, Jubbonti®) and biosimilars (Wellpoint Federal (MAC - Part A, MAC - Part B); 10 Level II codes)
- A58982: Billing and Coding: Erythropoiesis Stimulating Agents (Palmetto GBA (MAC - Part A, MAC - Part B); 9 Level II codes). LCD with the same title: L39237
- A54768: Billing and Coding: Cardiac Blood Pool Imaging (Multiple Gated Acquisition Scanning- MUGA, Ventriculography) When Performed in Conjunction with Cardiotoxic Chemotherapy (Palmetto GBA (MAC - Part A, MAC - Part B); 5 Level II codes)
- A56748: Billing and Coding: White Cell Colony Stimulating Factors (Palmetto GBA (MAC - Part A, MAC - Part B); 16 Level II codes). LCD with the same title: L37176
- A52480: Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC); 19 Level II codes). LCD with the same title: L33827
- A60381: Billing and Coding: Erythropoiesis Stimulating Agents (Wellpoint Federal (MAC - Part A, MAC - Part B); 9 Level II codes). LCD with the same title: L39237
- A56695: Billing and Coding: Implantable Infusion Pump (Palmetto GBA (MAC - Part B); 9 Level II codes). LCD with the same title: L33461
A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.
Other D05 diagnoses (Carcinoma in situ of breast)
- D05.90 — Unspecified type of carcinoma in situ of unspecified breast
- D05.91 — Unspecified type of carcinoma in situ of right breast
- D05.00 — Lobular carcinoma in situ of unspecified breast
- D05.01 — Lobular carcinoma in situ of right breast
- D05.02 — Lobular carcinoma in situ of left breast
- 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
- D05.80 — Other specified type of carcinoma in situ of unspecified breast
- D05.81 — Other specified type of carcinoma in situ of right breast
- D05.82 — Other specified type of carcinoma in situ of left breast
Frequently asked questions
Does Medicare cover D05.92 (Unspecified type of carcinoma in situ of left breast)?
Medicare covers items and services, not diagnoses. 13 Medicare billing and coding articles list D05.92 as a covered diagnosis for 93 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.
Which HCPCS codes can be billed with ICD-10 D05.92?
The Level II codes from the policies most specific to this diagnosis are L8035 (Custom breast prosthesis, post mastectomy, molded to…, 1 article); L8002 (Breast prosthesis, mastectomy bra, with integrated breast…, 1 article); L8001 (Breast prosthesis, mastectomy bra, with integrated breast…, 1 article); L8015 (External breast prosthesis garment, with mastectomy form…, 1 article); L8000 (Breast prosthesis, mastectomy bra, without integrated…, 1 article). Code choice depends on the item supplied; check each code's descriptor.
What does Medicare pay for equipment billed with D05.92?
Under the 2026 DMEPOS fee schedule (non-rural state fees): L8035 $4,403.11 to $5,283.69; L8002 $198.27 to $218.12; L8001 $150.77 to $165.83; L8015 $72.05 to $86.41. Medicare pays 80% of the allowed amount after the Part B deductible.
Which Medicare policy articles list D05.92?
A52478 (External Breast Prostheses - Policy Article); A56448 (Billing and Coding: Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography); A59160 (Billing and Coding: Luteinizing Hormone-Releasing Hormone (LHRH) Analogs), and 10 more articles.
What is ICD-10-CM code D05.92?
D05.92 is the ICD-10-CM code for unspecified type of carcinoma in situ of left breast, in category D05 (Carcinoma in situ of breast), chapter 2: Neoplasms.
Next steps
- Run a reimbursement report for a device billed under L8035
- Watch L8035 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L8035
Sources: CMS Medicare Coverage Database billing and coding articles (covered ICD-10 code lists and HCPCS links); ICD-10-CM FY2026; CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026 (non-rural state fees). Not billing or legal advice.