C00.1
C00.1 — Malignant neoplasm of external lower lip
Billable / specific codeICD-10-CM
C00.1 is a billable, specific ICD-10-CM code for malignant neoplasm of external lower lip. It is valid for submission on a claim.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Malignant neoplasm of lower lip NOS
- Malignant neoplasm of lipstick area of lower lip
- Malignant neoplasm of vermilion border of lower lip
Risk adjustment
C00.1 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Medicare coverage
C00.1 is named in 62 Medicare coverage policies — 62 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
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Related codes at this level
Codes that share C00. If C00.1 is not quite right, the correct code is usually one of these.
- C00.0Malignant neoplasm of external upper lip
- C00.2Malignant neoplasm of external lip, unspecified
- C00.3Malignant neoplasm of upper lip, inner aspect
- C00.4Malignant neoplasm of lower lip, inner aspect
- C00.5Malignant neoplasm of lip, unspecified, inner aspect
- C00.6Malignant neoplasm of commissure of lip, unspecified
- C00.8Malignant neoplasm of overlapping sites of lip
- C00.9Malignant neoplasm of lip, unspecified
Questions about C00.1
- Is C00.1 a billable ICD-10-CM code?
- Yes. C00.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does C00.1 sit in the tabular list?
- Neoplasms (C00-D49), in the block Malignant neoplasms of lip, oral cavity and pharynx (C00-C14).