C43-C44 — Melanoma and other malignant neoplasms of skin
ICD-10-CM codes C43-C44 cover melanoma and other malignant neoplasms of skin, within neoplasms. The block holds 213 codes across 3 categories, of which 149 are billable and 64 are header codes that cannot be submitted on a claim.
Risk adjustment in C43-C44
0 codes in this block map to a CMS-HCC, which means the diagnosis carries a risk-adjustment payment when it is documented and coded. Under-coding here is money left on the table; over-coding here is what audits are for.
- HCC 21 Lymphoma and Other Cancers
- HCC 23 Prostate, Breast, and Other Cancers and Tumors
What else to watch in C43-C44
- 78 codes are laterality-specific. They come in left and right pairs, and the pair is mutually exclusive on a single site: coding both without a bilateral code is a contradiction a scrubber should catch before the payer does.
- 149 codes are named in Medicare coverage policies. An LCD or NCD lists them as supporting medical necessity, or explicitly as not supporting it. Which applies depends on the MAC for your state.