C43.111 — Malignant melanoma of right upper eyelid, including canthus
C43.111 is a billable, specific ICD-10-CM code for malignant melanoma of right upper eyelid, including canthus. It is valid for submission on a claim.
Excludes1 inherited from the categories above C43.111
These are not written on C43.111, but they bind it: a note on a category applies to every code beneath it. Billing C43.111 with anything listed here is a denial.
Excludes2 inherited from the categories above C43.111
Also inherited, and the opposite of Excludes1: these conditions are not part of C43.111, but a patient can have both, so you may code both.
Other codes that can never be billed with C43.111
These codes carry an Excludes1 note pointing at C43.111. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading C43.111 alone.
- C44Other and unspecified malignant neoplasm of skin
Risk adjustment
C43.111 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 23 Prostate, Breast, and Other Cancers and Tumors0.186 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.
Medicare coverage
C43.111 is named in 93 Medicare coverage policies — 93 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A52450Billing and Coding: Paclitaxel (e.g., Taxol®/Abraxane ™)
- A52450Billing and Coding: Paclitaxel (e.g., Taxol®/Abraxane ™)
- A52479Oral Anticancer Drugs - Policy Article
- A52479Oral Anticancer Drugs - Policy Article
Code history
C43.111 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.
Related codes at this level
Codes that share C43.11. If C43.111 is not quite right, the correct code is usually one of these.
Questions about C43.111
- Is C43.111 a billable ICD-10-CM code?
- Yes. C43.111 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does C43.111 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 C43.111?
- C43.111 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above C43.111 (C43) and apply to it just the same.