C43
C43 — Malignant melanoma of skin
Non-billable headerICD-10-CM
C43 is a non-billable header ICD-10-CM code for malignant melanoma of skin. It cannot be billed on its own: choose one of the more specific child codes below.
Excludes1 — never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
- melanoma in situ (D03.-)
Excludes2 — not included here, but may coexist
The excluded condition is not part of this code, but a patient can have both. You may code both.
Other codes that can never be billed with C43
These codes carry an Excludes1 note pointing at C43. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading C43 alone.
Risk adjustment
C43 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.
Code to one of these instead C43
10 child codes. Green means billable.
- C43.0Malignant melanoma of lip
- C43.1Malignant melanoma of eyelid, including canthus
- C43.2Malignant melanoma of ear and external auricular canal
- C43.3Malignant melanoma of other and unspecified parts of face
- C43.4Malignant melanoma of scalp and neck
- C43.5Malignant melanoma of trunk
- C43.6Malignant melanoma of upper limb, including shoulder
- C43.7Malignant melanoma of lower limb, including hip
- C43.8Malignant melanoma of overlapping sites of skin
- C43.9Malignant melanoma of skin, unspecified
Questions about C43
- Is C43 a billable ICD-10-CM code?
- No. C43 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does C43 sit in the tabular list?
- Neoplasms (C00-D49), in the block Melanoma and other malignant neoplasms of skin (C43-C44).
- What cannot be coded together with C43?
- C43 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.